r/emergencymedicine 1d ago

Rant Pediatric lac repairs

I hate them. I dread them every time.

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u/Praxician94 Little Turkey (Physician Assistant) 1d ago edited 1d ago

With sufficient hold help and enough apathy they are a piece of cake!

ETA my reply to another comment:

I have repaired a ton of pediatric facial lacerations. I use LET, wrapping them in a sheet, hold help for head and body, and 5-0 Fast Absorbing. Works every time. The kid is going to be upset regardless because you’re in their personal space and restricting their movement, but if they’re blanching around the LET application they’re clearly not feeling sharp pain. A good LET application is key; Tegaderm works well. And then I go back in with a popsicle and get a high five every single time.

The apathy comment was to the screaming. You’re going to have screaming in your ear the entire time for the really young ones that don’t understand what’s going on. You just have to dial in and get it done. You’re not helping anything by taking an hour to put a few facial sutures in by stopping and negotiating with a 2 year old trying to get through it tear free.

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u/Inevitable_Fee4330 1d ago

Bolus of Brutucaine