Pearls for Abscess Incision and Drainage

Part 2 in a Series Abscess incision and drainage should be loved and adored by all emergency providers because another abscess is waiting just behind the curtain. This month we highlight general guidelines for abscess incision and drainage, and show how to treat one in the video below. We will follow up with some additional videos in the months to come focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.   Axillary abscess from hidradenitis. Photo by Martha Roberts.   The Approach n  Identification of an abscess appropriate for I&D. n  If unsure, use ultrasound to identify fluid. n  Consider the use of IV or PO pain medication. n  Incision and drainage (I&D). n  Packing application. n  Follow up with packing removal and/or surgical follow-up.   The Procedure n Consider premedicating the patient with oral Motrin, Percocet, or Vicodin, or IV medication if local infiltration is not sufficient. n Obtain laceration tray or surgical kit for I&D. n Put patient in comfortable position. n Prep using sterile gloves to keep it a clean procedure, though it is not meant to be a sterile one. n Anesthetize the skin with 1% lidocaine. Inject slowly. n Make a horizontal incision using an 11 or 15 blade scalpel, utilizing the entire length of the abscess. Do not make just a small stab. n Allow pus to discharge freely at first, and then assist with gentle expression of the opened cavity. n ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs