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By Michelle Lin
Medical Doctor
Specialty: Emergency Medicine
Blog: http://academiclifeinem.blogspot.com
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Michelle Lin's Twitter Updates

@precordialthump I totally forgot about the EKG library! Awesome stuff. Keep up the great work (when do you sleep?!) 258 days ago
@emeducation Perfect, thanks for the suggestions! Turns out one is co-authored by Jeff Tabas. He already gave them all books. 258 days ago
Recommendations for an EKG resource to review bread & butter cases for senior residents? Pre-graduation panic setting in for our residents. 258 days ago
@danipedia Good point. I use the studies to convince the trauma consults NOT to get c-spine imaging on EVERYONE (citing distracting injury)! 263 days ago
@doctorflash Hi there. Just wanted to drop a note to thank you for all the extra traffic you're sending to blog. Much appreciated!! 273 days ago
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Trick of the Trade: Fingertip injuries

Posted Jun 08 2011 12:00am


Fingertips can get injured in a variety of ways such as machetes, meat grinders, and broken glass. You name it, and we've probably seen it. Some don't actually need anything invasive done because the skin is basically just torn off. The wound just needs to be irrigated, explored, and then bandaged to allow for secondary wound closure.

What do you do if the finger injury keeps oozing and the finger tip is too painful for the patient to apply firm pressure? Poking the finger with 2 needles to perform a digital block seems a bit overkill.

Trick of the Trade:
Soak the digit in 1% lidocaine with epinephrine for 5 minutes

Pour 10-20 cc of 1% lidocaine with epinephrine into a small, sterile urine specimen cup. Have the patient dip his/her fingertip into the solution. The lidocaine will anesthetize the wound, and the epinephrine will help achieve hemostasis.

After irrigation and better examination of the wound, you can now apply a topical hemostatic pad (eg. Surgicel, Gelfoam) over it and wrap the finger with tubular gauze.

Thanks to Dr. Mak Moayedi (Univ of Maryland) for this great trick!

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