Pediatric Fingertip Injury

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Nurses Edition Commentary

Mizuho Spangler, DO, Kathy Garvin, RN, and Lisa Chavez, RN
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Tom T. -

After treating finger tip amputations for decades with digital block then controlling bleeding (the most challenging aspect in my experience) with hand held cautery, I've changed my technique to soaking in lido/epi for 15 minutes, tourniquet to control oozing then applying derma bond when bleeding stops. I'm pretty sure this is a technique Michelle Lin mentioned.

Clifford D. -

I understand that the removal of the nail bed is recommended if disruption is present, but there was no mention of whether the nail should be re-attached to provide a splint to heal (or if suture foil was recommended if the nail was too damaged to be replaced). Would someone please comment on this?

Paul -

Can skin adhesive be used to repair nailbed

Michael S., PA-C -

Can someone add the references that show no increased gain from antibiotics in these injuries? I would greatly appreciate it.

Thanks

Mike

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Shock, Asthma, and Fingertips Full episode audio for MD edition 246:13 min - 343 MB - M4AEM:RAP 2016 June Canadian Edition Canadian 18:39 min - 26 MB - MP3EM:RAP 2016 Junio Resumen Español Español 91:44 min - 126 MB - MP3EM:RAP 2016 Juin Résumé en Francais Français 58:51 min - 81 MB - MP3EM:RAP 2016 June Aussie Edition Australian 32:29 min - 45 MB - MP3EM:RAP 2016 June German Edition Deutsche 122:57 min - 169 MB - MP3EM:RAP 2016 June Board Review Answers 172 KB - PDFEM:RAP 2016 June Board Review Questions 237 KB - PDFEM:RAP 2016 June MP3 300 MB - ZIPEM:RAP 2016 June Written Summary 809 KB - PDF