Sounds like you're being pretty aggressive with your cleaning.amysdad said:do you guys have any tricks of the trade for road rash??? I give a bucket load of dilaudid and get to cleaning and my pt's still scream. Lido jelly? Emla?
Please remember that lidocaine does have a maximum, weight-based dose. Depending on the absorption (ie depth of abrasion) you may need to consider other methods for debridement -- ketamine in the appropriate patient, perhaps? -- to avoid lidocaine toxicity.stoic said:get out your lido jelly and apply generously. then grab a handful of 4x4's and start debriding. i've seen and found that you sometiems you really have to get aggressive with it but if you use enough pain meds and lido the pt is comfortable enough and you end up getting a lot more of the debris out.
as long as they are still doing Bier blocks i'm not going to worry about lido toxicity with topical lido jelly on road rash. yea they probably get a decent dose of it if you use a ton for like an hour, but the absorbtion is slow enough that its not going to be causing any seizures. with the bier blocks i've seen they never seem to wait more than 2 minutes from beginning to release pressure to having the tourniquet completely off and that bolus dose is WAY bigger than what they're getting over the entire duration of the debridment.Pose said:How much lido jelly would be needed (on your average patient model) to cause toxicity?
oooooo it would be good for I&D's. those folks can be so hard to get comfortable even with a ton of narcotics on board... and the local sometimes seems completely useless. you could probably cut back the narcotic dosage quite a bit using some adjunct nitrous. i'm gonna find out if we have that here in my med school's ed. if we don't maybe gas could cart some down. i'm anxious to give it a shot on the next big bad abcess i dig into.roja said:We use it all the time... I love it.. its not just for peds.. shoulders, fractures, difficult i&d's, etc.