2.50
Hdl Handle:
http://hdl.handle.net/10755/163013
Type:
Presentation
Title:
Painless Stitches
Abstract:
Painless Stitches
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Riecks Esposito, Kim, RN, BSN
P.I. Institution Name:Aultman Hospital
Title:Registered Nurse
Contact Address:9633 Beryl Street NW, Canal Fulton, OH, 44614, USA
Contact Telephone:(330) 363-6788
Purpose: Review of the existing wound anesthesia protocol revealed liquid-LET (lidocaine, epinephrine, and tetracaine) as the treatment of choice for wound anesthesia prior to lidocaine administration. Historically, it has been observed that lidocaine injected into the wound was perceived to be a painful experience for children and their families. The purpose of this research project was to introduce an alternative to wound anesthesia, a gel-LET product, yielding the "painless stitches" concept. This method of wound repair decreases pain and makes the ED experience less traumatic for children, their families, and staff. Design: A performance improvement project was implemented to introduce the gel-LET product and method of application to ED personnel. Setting and Subjects: The gel-LET protocol was applied to pediatric patients, ages 14 and under, in this urban, Level II trauma center with 75,000 patient visits annually. 5,217 of the 8,327 year-to-date (2004) pediatric ED visits were seen in the dedicated pediatric emergency department. Methods: Six surrounding area pediatric emergency departments were benchmarked. Literature was reviewed for best practice. Collaboration included the Director of Pharmacy, the Emergency Department Medical Director, ED physicians, and ED physician assistants. Cost analysis was completed. ED staff was in-serviced on how to use the gel-LET product. A departmental policy was written and the gel-LET protocol was then implemented. Results: The FLACC (face, legs, activity, crying, and consolidation) scale was utilized to evaluate the nonverbal pediatric patients, while the Wong-Baker FACES scale was applied to the verbal/cognitive pediatric patient during the suturing procedure. Verbal patients stated gel-LET analgesia was sufficient. Non-verbal patients did not produce a painful cry when the suture needle punctured the skin. Parental interviews generated an increased comfort level with regards to their children receiving stitches. An informal survey among ED personnel determined that gel-LET, without injectable lidocaine, was an effective means of wound anesthesia. The above evaluative measures concluded that gel-LET is approximately 98% effective on facial and scalp lacerations compared to liquid-LET at approximately 5%. The effectiveness on extremity lacerations appears to fall off slightly due to the decreased circulation to these areas. Recommendations: Currently, different methods of heat application over the gel-LET product in extremity lacerations are being explored. By increasing circulation to these areas with heat, it is anticipated that there will be an increase in the efficacy of the medicine. "Painless Stitches" provides non-traumatic suture repair to pediatric patients in the emergency department. Furthermore, it increases patient, family, and staff satisfaction, and can be easily implemented in any emergency department.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePainless Stitchesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163013-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Painless Stitches</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Riecks Esposito, Kim, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Aultman Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Registered Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">9633 Beryl Street NW, Canal Fulton, OH, 44614, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(330) 363-6788</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">KimREsposito@aol.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Review of the existing wound anesthesia protocol revealed liquid-LET (lidocaine, epinephrine, and tetracaine) as the treatment of choice for wound anesthesia prior to lidocaine administration. Historically, it has been observed that lidocaine injected into the wound was perceived to be a painful experience for children and their families. The purpose of this research project was to introduce an alternative to wound anesthesia, a gel-LET product, yielding the &quot;painless stitches&quot; concept. This method of wound repair decreases pain and makes the ED experience less traumatic for children, their families, and staff. Design: A performance improvement project was implemented to introduce the gel-LET product and method of application to ED personnel. Setting and Subjects: The gel-LET protocol was applied to pediatric patients, ages 14 and under, in this urban, Level II trauma center with 75,000 patient visits annually. 5,217 of the 8,327 year-to-date (2004) pediatric ED visits were seen in the dedicated pediatric emergency department. Methods: Six surrounding area pediatric emergency departments were benchmarked. Literature was reviewed for best practice. Collaboration included the Director of Pharmacy, the Emergency Department Medical Director, ED physicians, and ED physician assistants. Cost analysis was completed. ED staff was in-serviced on how to use the gel-LET product. A departmental policy was written and the gel-LET protocol was then implemented. Results: The FLACC (face, legs, activity, crying, and consolidation) scale was utilized to evaluate the nonverbal pediatric patients, while the Wong-Baker FACES scale was applied to the verbal/cognitive pediatric patient during the suturing procedure. Verbal patients stated gel-LET analgesia was sufficient. Non-verbal patients did not produce a painful cry when the suture needle punctured the skin. Parental interviews generated an increased comfort level with regards to their children receiving stitches. An informal survey among ED personnel determined that gel-LET, without injectable lidocaine, was an effective means of wound anesthesia. The above evaluative measures concluded that gel-LET is approximately 98% effective on facial and scalp lacerations compared to liquid-LET at approximately 5%. The effectiveness on extremity lacerations appears to fall off slightly due to the decreased circulation to these areas. Recommendations: Currently, different methods of heat application over the gel-LET product in extremity lacerations are being explored. By increasing circulation to these areas with heat, it is anticipated that there will be an increase in the efficacy of the medicine. &quot;Painless Stitches&quot; provides non-traumatic suture repair to pediatric patients in the emergency department. Furthermore, it increases patient, family, and staff satisfaction, and can be easily implemented in any emergency department.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:02Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:02Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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