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.
The lecture Linear Anesthesia by John Russell, DNP, APRN, AGACNP-BC, FNP-BC, CCRN, CRNFA is from the course Suturing.
How is linear anesthesia performed in an existing laceration?
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