In response to Dr. Wiley's comments:
One way to bypass the problem of staple removal by local physicians is by
dispensing a staple remover to the family to give to the primary M.D.
This does not however resolve the problem if the local doctor does not
know how to use the staple remover. Alternatively, have the patient return
to the E.D. for staple removal. I believe that some payors bundle the
cost of staple/suture removal with the cost of their placement.
As for the issue of using one or two staples without anesthesia... Some
general E.D.s do not yet stock LET or TAC! The questions then raised are
is it worth the needle stick for infiltration of anesthetic if only 1 or 2
staples are being placed, and why do they not have LET?
Zach Kassutto, M.D.
St. Christopher's Hospital for Children
eMail: [log in to unmask]
> Date: Mon, 23 Dec 1996 11:19:50 -0500
> From: James Wiley <[log in to unmask]>
> Subject: Stapling lacerations
> I would add another issue regarding stapling in the ED: difficulty in
> removing staples. At CCMC (Hartford, CT) most community physicians
> are unfamiliar with how to remove staples and do not have the
> necessary equipment. Before you do it, make sure the person who
> ultimately will remove them is able to do so.
> Second, I am surprised that people would consider stapling a child's
> head without analgesia, especially since LET or TAC is readily available
> in most institutions. I certainly wouldn't want my child stapled without
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