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As the forum's been a little dead of late I figured I'd kick this thread off. Share your pearls, interesting cases, etc for our new young docs just hitting the wards.
I'll start. For facial lacerations, make sure you examine and document the following (when relevant):
1. Full facial nerve exam. Know your anatomy of the facial nerve, where it's in danger from laceration, and how to check all the branches
2. Parotid duct Know where it runs in relation to the laceration. Be able to document that it's intact on any deep laceration to the cheek.
Also, learn how to do basic nerve blocks like mental, infraorbital, etc. These can help a lot especially in aesthetically sensitive areas where infiltrating a bunch of local can distort landmarks.
Remember that epi takes 15-20 minutes to achieve full vasoconstrictive effects, so don't be afraid to inject it and then go type up your note and grab a soda while you wait for it to fully kick in.
I'll start. For facial lacerations, make sure you examine and document the following (when relevant):
1. Full facial nerve exam. Know your anatomy of the facial nerve, where it's in danger from laceration, and how to check all the branches
2. Parotid duct Know where it runs in relation to the laceration. Be able to document that it's intact on any deep laceration to the cheek.
Also, learn how to do basic nerve blocks like mental, infraorbital, etc. These can help a lot especially in aesthetically sensitive areas where infiltrating a bunch of local can distort landmarks.
Remember that epi takes 15-20 minutes to achieve full vasoconstrictive effects, so don't be afraid to inject it and then go type up your note and grab a soda while you wait for it to fully kick in.
