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TROUVAILLES ET ASTUCES
Index général
3.1 Comment enlever un fragment de verre de la plante du pied? "Poser un pansement discoïde troué en son milieu, et d'une épaisseur de 2 mm. Au besoin, en coller deux l'un sur l'autre, bien centrés sur la plaie, puis faire marcher le patient. Comme avec un tire-comédon, on répartit les forces de pression de manière uniforme et le corps étranger aura tendance à ressortir après quelques heures." Dr P-P. Martin, Tribune Médicale No38, 18.9.98 3.2 Comment éviter la formation d'un ongle incarné? Dire au patient de toujours couper l'ongle de son gros orteil à angles droits sur les bords, et non en les arrondissant. Pour cela, utiliser le côté convexe du coupe-ongles. 3.3 Rinçage d'une plaie - Wound Irrigation Alternative An effective wound irrigation system can be made using a 250-cc plastic bottle of normal saline. Remove the protective outer cover to reveal the sterile screw-cap underneath (do not unscrew). Using an 18-gauge syringe needle, carefully punch a hole in the top of the plastic screw-cap. The bottle can then be squeezed to produce a jet of sterile saline for wound irrigation. This technique is more convenient than using a syringe and intravenous catheter as it provides 250 cc of saline without needing to reload. Ronald A. Berry, RN, MS, FNP, Lander, Wyo 3.4 Hémostase buccale - Stanching Bleeding in the Mouth To stanch the bleeding from the site of a dental extraction, have the patient apply a tea bag to the site and have the patient bite down on it for 15-20 minutes. The tannic acid serves as an effective hemostatic agent. Wesley Smith, MD, Anderson, SC 3.5 Minimiser une cicatrise de biopsie - Smaller Biopsy Scars When performing a punch biopsy, stretch the skin above and below the site, after making sure to stretch the skin perpendicular to the normal skin crease. Take the biopsy sample, then release the skin. When the skin retracts it will draw the opening into a more closed position, resulting in a smaller scar or less need for a suture. Jason Kruse, PA, Wichita, KS 3.6 Traitement des phlyctènes - Defeating Blisters Blisters on part of the skin are easily conquerable without puncturing the skin or removing the skin over the plasma/extracellular fluid secretion. Depending on the size of the affected area, mix 2oz to 10oz of beta iodine and table sugar into a consistent and thick paste. Gently administer the paste to the affected area(s) and place 1cc to 5cc of iodine solution to the paste. The sugar serves to open the skin on a cellular level so that a form of diffusion may take place; sugar simply opens the door for the extracellular fluid, and plasma may be aborbed absorbed by the sugar itself. The iodine serves to sterilize the area until the epidermis re-acclimates to the dermal layer. The duration of treatment is different for almost everyone, but eventually it will work. This simple procedure promotes patient comfort, and protection against sepsis, and is an effective way to alleviate some of the suffering associated with sunburn, second-degree burns and blisters from outdoor activities and sports. For blisters occurring from home accidents, examine the patient thoroughly for deep tissue injury first. Richard Lea, Shreveport, LA 3.7 Traitement des furoncles - Pediatric Furuncle Alternative To expedite the healing of a furuncle nonsurgically, cover the lesion with Tegaderm(TM) film for a day. The lesion's purulence can then be easily expressed with minimal pain. Susan Schmalzle, NP, Miami, FL 3.8 Traitement du pityriasis versicolor - Treating Tinea Versicolor In an individual with tinea versicolor, ketoconazole is excreted in large amounts through perspiration. Instruct the patient to take 400-mg ketoconazole orally once daily then, about 2 hours later, to exercise vigorously. Perspiration will treat the infection. Repeat if necessary in 1 month. Scott Osborne, PA-C, Longview, TX 3.9 Huile de castor contre les verrues - Castor Oil Dissolves Plantar Warts For fearful patients or those who have not had success with keratolytics, lasers, or cryotherapy for plantar warts, try castor oil. Have patients apply the oil to the warts twice daily using an adhesive bandage as an occlusive dressing. With persistence and patience, this method will work on the most stubborn plantar warts. Unlike other techniques, it is painless. Meg Hogenauer, PA, Libertyville, Ill 3.10 Sève de chélidoine contre les verrues - Chelidonium majus sap against warts
3.11 Saving Hair - Suturer sans raser Prior to suturing a scalp wound, use K-Y Jellyreg. to "gel" the patient's hair away from the laceration. This eliminates the need to shave the area around the wound. [Clinician Reviews 6(9):24, 1996. ©1996 Clinicians Publishing Group and Williams & Wilkins.]
3.12 Freezing Skin Lesions - Cryothérapie très précise When freezing small skin lesions with a liquid nitrogen "cryo-gun," clinicians often overspray and ultimately damage healthy tissue. To avoid inflicting collateral skin damage, use an otoscope speculum like a funnel to pinpoint the blast of liquid nitrogen.
3.13 Piqûre sans enflure - Sting without swelling Pour contrer l'enflure et la réaction allergique à une piqûre
d'insecte, il suffit, à l'aide d'un crayon, d'un stylo, ou même
d'un ongle, de tracer un cercle autour du point de ponction;
cela aura pour effet d'écraser les vaisseaux lymphatiques. Le
résultat est spectaculaire, même chez les personnes très
allergiques: l'odedème et les démangeaisons seront minimes et ne
dépasseront pas ce cercle. Dresse C. Lehmann, Genève 3.14 Protection contre les métaux allergisants - Protection against metal allergy Le nickel est une cause fréquente d'allergie de contact,
notamment en relation avec les boutons métalliques des jeans.
Une des solutions consiste à enduire le bouton en cause avec du
vernis à ongles incolore.
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