Linear Anesthesia


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    00:05 In this video, I'd like to show you the concept of a linear anesthesia.

    00:09 Typically done when you have an incision you're going to create.

    00:13 The way this works is you simply start from the proximal side of the incision, and you provide a line of a bleb, so to speak.

    00:22 So you would inject through the tissue.

    00:24 And then as you advance the needle across, above the skin, I'll show you what's happening beneath the skin.

    00:30 You basically advancing your needle underneath your wound as you're giving a bleb, and you go as far as you can.

    00:36 And then you stop, take your needle out.

    00:39 If you need to reload with more lidocaine or whatever you're choosing to use.

    00:42 And then you'll pick up where you left off and keep on going inside the tissue until you get to the point where you've met your distal end.

    00:50 That way, you have a nice bleb that goes all the way down where your incision is you've covered the patient adequately with linear anesthesia.

    00:58 That said, this is option number one for let's say, if you have wounds that you're going to create.

    01:04 If the patient presents to you with an incision that's already made, let's say from a laceration from some blunt force trauma, which you can choose to do if you've already gone through the process of cleaning out your wound and providing good anesthesia.

    01:17 If necessary prior for something more original for a large laceration with like an anesthesiologist.

    01:24 Or if you have something smaller going on here, you may choose to perform this procedure going through the incision outward.

    01:31 So if you have a laceration that you feel is appropriate to close, you can actually give anesthesia through this outwards.

    01:38 So sometimes what you'll see people do is they'll go in.

    01:40 So it's kind of like fanning out like the sun.

    01:44 And they'll go through the sidewall, the dermis.

    01:47 And the first thing I'd recommend you do if you have a laceration that's open is to drip lidocaine in there, because the skin barrier is already broken, and the pain is already there.

    01:56 So you have the benefit of going directly to the deeper dermis with anesthetic.

    01:59 Let it kind of sit there for a minute or two, and then go ahead and start fanning out through the sidewalls of the tissue.

    02:05 If a wound is clean enough to close, it's cleaned out to get anesthesia through the insides of the incision.

    02:11 As opposed to having to make multiple pokes on the outside and penetrate the tissue more.

    02:16 You're better to work through the one incision you already have.

    02:18 So go ahead and practice this.

    02:20 Just to kind of visually understand how to do this with your needle and syringe.

    02:25 Again, it won't actually react in the tissue as well.

    02:27 It's not going to bleob up for you. But you understand the concept that want to least do the proper hand movement.

    02:31 So go ahead and practice that on your own.

    About the Lecture

    The lecture Linear Anesthesia by John Russell, DNP, APRN, AGACNP-BC, FNP-BC, CCRN, CRNFA is from the course Suturing.

    Included Quiz Questions

    1. Injecting anesthesia through the laceration, fanning out from one end to another.
    2. Injecting anesthesia underneath the wound, starting at the distal end.
    3. Injecting anesthesia in a “V” pattern at the proximal end of the wound.
    4. Injecting a singular bleb of anesthesia under the middle of the laceration.

    Author of lecture Linear Anesthesia



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