Jeanette Welsh

Lidocaine

How to administer lidocaine in wounds

Rationale and key points Before a wound can be cleaned and/or closed, the use of a local anaesthetic such as lidocaine is often required to enable the nurse to assess the wound thoroughly and plan the optimal method of repair. This article explains how to administer lidocaine safely and effectively, including how to infiltrate a wound with lidocaine before cleaning or suturing. There are potentially serious consequences associated with the use of local anaesthesia, but careful preparation will ensure patient safety and contribute towards a positive patient experience. » The nurse should have an understanding of how lidocaine functions, the speed at which it will take effect, and the duration of the mode of action. » The nurse should have knowledge and awareness of the risks associated with the use of lidocaine to ensure patient safety. » The nurse should prepare the equipment and the patient for the procedure. Reflective activity How to articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might improve your practice. 2. How you could use this information to educate your patients and colleagues on the appropriate technique for administering lidocaine in wounds.

Book_Reviews_07

Book review: Oxford Handbook of Emergency Nursing

Now in its second edition, this handbook on emergency nursing is invaluable.

Managing hypopituitarism in emergency departments

Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient’s complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband.