Ask the Expert: Kenji Inaba Answers Hot Questions in Trauma

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Todd C.
Would suggest some pointers to the resident (?) and viewers the following. On the finger lac if the wedding band was readily removable, it should have been. Adequate tourniquet control of the bleeding digit was not accomplished. There are several pointers here. The cut latex glove finger tourniquet was not tight enough. A commercial device that works great and have used for years is the "tournicot" . Comes in various sizes and is easy to use and provides broad based circumferential pressure sufficient for hemostasis without much risk for NV bundle injury. If this is not available a small penrose drain with clamp is an alternative. Lastly, EP's should be familiar with self-retaining retractors which come in very small (fingers and delicate small lacerations) and large sizes (for scalp or large wounds). We shouldn't sew what we can't see and explore. A bloodless field is imperative. Running locking sutures are very good for bleeding scalp lacerations. Learn it!