Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
I don't especially like writing articles that are mainly
common sense, but as long as these injuries keep showing up
in my emergency department, they need to be stressed. In the
business we call it "industrial emergency medicine."
Falling off ladders is common -- I once broke an arm that
way. Have an assistant stabilize the ladder and don't climb
to the top step.
Eye protection and heart protection are essential.
Splinters, sawdust and small metal fragments from hammering
nails and other metals commonly find their way into the
eyes. I have also seen lulav tips scratching the eye.
Beware of falling beams when taking apart the Succa or
something similar. Especially beware of small children
wandering in -- let them watch from a distance.
Splinters from wood are quite common to everyone working
with wood. Larger ones that are deep in tend to leave small
pieces behind -- be careful. We in general make a slightly
larger hole in the skin to make sure we get it all out.
Scrubbing or irrigating the area with soap and water is your
best protection against infection. Special disinfectants
such as iodine are unnecessary and may make things worse.
The best bet is to buy a good set of work gloves.
Most of what I have written goes for lacerations as well,
but please act faster on getting them taken care of and make
sure your physician checks that you didn't tear any tendons
when you cut yourself.
Hitting your finger with a hammer is a painful injury as is
any heavy objecting falling on your finger. Fractures are
common in the bones underneath the fingernails and toenails.
Fortunately, these are not serious injuries.
Bleeding underneath the nail is very painful, and making a
hole in the nail often gives much relief; however, if the
bleeding covers greater than 50% of the nail, it is likely
that the nail is lost and the body will most often just
replace it with a new one. A good set of work shoes may
avoid this problem at least for the feet.
Ever staple yourself? We see a lot of these injuries from
staple guns and, surprisingly, we see a similar type of
injury in women -- often needles from sewing machines get
caught in their fingers. The temptation is to just pull it
out fast. I would prefer that you go to your physician and
have him check the area first before he removes it under
sterile conditions.
The Succa should be stored in a place where the children
will not be playing. Often succas are stored in dark places
such as a garage. In many climates that is an invitation for
spiders, scorpions, and snakes. Be very careful when you
take them out next year, and the best thing you could do to
help us help you in case of such a bite is to try to let us
know what the biting creature looked like. While capturing
it would also help, it wastes time, and most emergency
physicians I know would prefer you didn't bring live snakes
into their emergency departments -- we're out of space.
Write me in care of the Yated.
A message from Glaxo, the sponsor of this column.
Sinusitis should not be treated with antibiotics unless it
lasts for more than week or one is pretty sick. If that is
the case, then your number one choice is Zinnat. With its
ability to cover resistant organisms, it is a safe
bet.
