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90 min. before my Sunday night shift, our 2 year- old, Titan, comes screaming up the stairs looking like a scene out of a slasher horror movie. His older sister sheepishly admitted to chasing him into the edge of a door frame. We created an ED bed on our kitchen counter and slipped a pillow case up his arms, behind him, with him laying on it, to help restrain him, telling him it was a super hero cape. I wanted to use Dermabond, but I couldn't get the wound edges to approximate like I wanted them to. If the wound was above the hairline, I could have used the stapler. Recruiting his 4 older siblings and my wife to help soothe him and hold him down, I anesthetized the wound with injectable 1% lidocaine, irrigated it with sterile saline, 60 cc syringe, and a splash guard, prepped it with drapes and betadine, and then closed it, using 6-0 Ethilon on a P-3 needle. He took it like a champ! It was nice not to have to take him in to the ER and it was a good experience for my family. I enjoyed showing them what I do as an ER doctor. I had everything I needed that I am used to using in the ER. The evening was saved. Time and money was saved. I maintained my autonomy, caring for my own child. I was affordably prepared, without swiping materials from the hospital, maintaining my integrity. It's good to be a Provider Prepared!
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