Can an undergrad student suture a trauma patient?

Discussion in 'Emergency Medicine' started by Med1992, Aug 1, 2015.

  1. Med1992

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    Hey guys. There's a person from school claiming to be suturing up trauma patients (and he's a freshman in college) at either a medical assistant job or a shadowing job that he just got like a week ago. I think that sounds really cool and is something people I know would be interested in learning how to do as well, but...

    I call his bluff because it doesn't sound right to me. Is it legal and/or ethical for an undergraduate student 19 years old to be suturing up a patient?
     
  2. Pons Asinorum

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    Not ethical. Highly doubt this story.
     
  3. Makati2008

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    Didn't happen. Not ethical but maybe if this is a small town in the middle of nowhere....
     
  4. link2swim06

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    On his own...highly doubtful.

    If the attending is by his side and let him put a steri-strip or some dermbond on then maybe. I can see how that could morph into a story about "suturing up trauma patients."
     
  5. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu...
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    It seems unlikely. Then again, I know people that claim they sutured as pre-med volunteers at Cook County. These people have nothing to gain with such a lie.
     
  6. Med1992

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    So specifically, this person (who is really annoying btw) claims that he asked a nurse to hand him a 3.0 vicryl at trauma so that they could suture up the patient and that they had no clue what to do... but like I said, I'm pretty sure its BS. And its not a small town btw, its actually a big metro area.
     
  7. Apollyon

    Apollyon Screw the GST
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    As so many people talking and calling "BS" are residents, I'll tell you one (that isn't). A classmate of mine in med school, in the 90s, in Denver, sewed up many drunk heads. Of course, being a pre-med, the results weren't great (at least at first), but the patients didn't realize it.

    However, 3-0 Vicryl? On two counts, that is BS. That throws the rest of the story into question.
     
  8. Med1992

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    Can you explain the last part about vicryl? I have no idea what that even is, I'm just quoting a social media post haha... and very curious to determine if its the truth or not
     
  9. Mad Jack

    Mad Jack Critically Caring
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    While he was a med student? That's believable. Or if he was an amateur that had a lot of rowdy friends lol (I knew a guy that did tattoos and piercings that would happily sew wounds closed for friends and acquaintances).
     
  10. Apollyon

    Apollyon Screw the GST
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    No, she was pre-med (I thought I said that). (Sorry if not clear.)
     
  11. Med1992

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    Wait can you elaborate on the last part!? Like how does that throw it even more into question is what I'm wondering
     
  12. Apollyon

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    3-0 - arguably too big (4-0 should be enough). Then, Vicryl? Absorbable in the scalp? Quite unlikely. In other body parts - even more unlikely. (That is, Vicryl is an absorbable suture.)
     
  13. Med1992

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    Lol... I almost wanna call him out on it, but I shouldn't. I just hope everyone else doesn't start idolizing him as this "pre-med" or "medicine" expert that they look up to and admire.
     
  14. Birdstrike

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    Right. 3-0 vicryl is an absorbable for multilayer closures you don't do in EM that often (used constantly in the OR, however) not to mention that when you do, it tends to be used in a deeper or more complex laceration, it's not something you throw to a sub-medical student, that's not even enrolled in medical school. It would be the same as allowing your grandma to suture for you, "'cause she throws a mean noose knot."

    I'm pretty sure that you would generally have to be, at a minimum, enrolled in a medical, PA or NP school to suture and supervised, at that. So, it's one of two things, either a made up story, or a doctor going out on a limb to let a pre-med do more than he probably should. You'll get all the suturing experience you need sewing a dead chicken once the day before you actually suture somebody.
     
  15. USCDiver

    USCDiver Percocet-R-US
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    I vote for cutting suture for the doc while shadowing a family friend who is a general surgeon in a small town.
     
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  16. emememem

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    The story sounds like BS for sure but I think you have more to lose by calling this person out. Be a good sport and let people figure out he's a phony on their own.
     
  17. shookwell

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    I use absorbable sutures for scalp lacs on drunks . . . I don't trust them to come back
     
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  18. Birdstrike

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    Why the hell not a dab of betadine, squirt of saline, then staples?

    "Squirt, splash, chunk-chunk-chunk-chunk home!

    Hell. These will heal practically no matter what you do, and hardly even even get infected either.

    Or are you worried about cosmetics and "drunk bald-head guy" modeling career concerns?
     
  19. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu...
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    Staples don't need removal?
    I staple unless something else is needed for hemostasis.
     
  20. Birdstrike

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    Well...I guess, so. Lol
     
  21. Angry Birds

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    I use absorbable staples.
     
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  22. Birdstrike

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    Iron staples. After 10 years they rust away. Also can be used to meet meaningful use and PQRS. Press Ganey...not so much.
     
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  23. filhodeinferno

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    He'll probably bomb O-chem and not get in anyway.
     
  24. suckstobeme

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    We train our techs to do simple lacs. They can sew anywhere except the face and if it's multilayerd, they only do the first layer. They staple scalp lacs all the time. They generally do a good job and I trust them more than any med student, all of our internal med residents, and most of our family practice residents. In fact, I often ask them to supervise some of the residents after I see the resident throw the first stitch. Not to put the residents down, but the techs just do it waaaaay more. This is a job where experience matters more than knowing all the ins and outs of wound healing.
    Why would it be unethical?
     
  25. cyanide12345678

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    I sutured up a trauma patient all by myself without supervision as a 4th year medical student. I felt highly incompetent and took more than an hour. Can't image a 19 year old doing it :p
     
  26. Pons Asinorum

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    Because your techs are trained, paid, and insured by the hospital to perform patient care tasks in your emergency dept, and a freshman college student shadowing in an ED is none of those things. How would patients feel if after the fact it was explained to them that a college freshmen fulfilling a soft requirement for applying to medical school (if they get around to it in 3 years) was allowed to independently perform an invasive part of their care when it was completely unnecessary? Contrast to that same conversation when an EMT has necessarily done the work. Seems unethical to me. I could certainly be wrong, but I would never allow it.
     
  27. goodoldalky

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    I will use vicryl for unruly deep scalp bleeders for emergent hemostasis. Nothing against a 3-0 either. It's absorbable, it's tough and won't break with a strong figure of 8 knot, etc. Prolene and ethilon aren't the best for this purpose, they can't be left in, and more rapidly absorbing sutures except maybe vicryl rapide are too weak to do the job. Plus you can always have an absorbable suture removed just like a permanent one on follow-up if need be. Although barring an arterial bleeder there's no reason to do anything but staple it.
     
  28. suckstobeme

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    I don't know if the OP said the kid was just shadowing. I might have missed that part. I thought maybe the guy just got legit hired by the ED.
    Many of our techs are college students looking to make extra money and gain experience (many more are working on becoming EMTs). About 30% end up applying to med school or PA school. A large chunk also go on to nursing school. There is nothing unethical about it. It also saves me a ton of time.

    Side note: I'm much more worried about college students working as scribes writing in the EMR than about college students suturing simple lacerations.
     
  29. Pons Asinorum

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    I guess we're each coming at this with our own presuppositions. I heard blowhard college freshman, and I assumed shadowing future applicant, not employed ED tech. Legit ED techs/EMTs, who have been trained in those procedures, absolutely sew lacs. Would agree with the concerns about the scribes, but again I assume a certain amount of necessary oversight.
     

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