Hello, med students. My name is Zach Olson, and thank you for downloading this episode of the EM

Clerkship Podcast. Today is part two of our two-part series on Lacerations. Last week we discussed

how important it is that you really need to master these basic procedures because you may only get a few chances to perform them during your clerkship.

Specifically, we discussed your initial evaluation when a patient comes in with a laceration.

Just to review where we are so far, remember, we've done a history with a focus on chronic illnesses,

the age of the wound, mechanism, location, and contamination. If the wound was dirty, which is the

majority of the time in the emergency department, then we gave a tetanus shot if it had been more than

five years. Also, if the wound had tetanus in it and they likely had never had a tetanus shot

before, maybe they're from a foreign country, that is when we give the tetanus immune globulin,

although that's very rare. We took a ruler, we measured and described the wound to the attending,

as well as performed a quick neurovascular exam, and then last we got an x-ray or an ultrasound

to look for foreign bodies if necessary. So you put all of that in your presentation,

and your intending is super impressed and they're

going to let you repair this laceration.

So let's walk through this because it can be intimidating, all of those suture types and needles

and tying techniques, but I promise this isn't actually that complicated.

Don't overcomplicate things.

Step one.

Pain control. Pain control first. You get a syringe with a small needle. I don't care what size of a needle and you grab some lytocaine.

If your attendings want to teach you nerve blocks and things like that, that's awesome. But you

aren't expected to know that yet as a student.

We aren't covering that today.

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