Bryan I. Fagan
丁香诊所 急诊科
丁香诊所全科培训课程 14:处理皮肤异物 有效降低感染率

丁香诊所全科培训课程 14:处理皮肤异物 有效降低感染率
  • 皮肤病

皮肤异物是由于异物穿透或磨损皮肤所致,有时难以识别或移除,甚至导致感染。 

皮肤异物可分为有机异物和无机异物,前者一般通过 B 超发现,发生感染几率高,需要移除,而后者则一般通过 X 线识别,发生感染几率较低,若未移除,也可能为机体所机化。

以下是几个常见病例及处理方法:

1. 射钉枪:在消毒、麻醉后,可直接拔出。

2. 碎木屑:首先消毒、局麻。对于简单可见的碎木屑可用镊子直接移除;对于未知深度的碎木屑,在移除前需确定长度,不可盲目探查,有时可能需要扩大切口,严重病例需转诊外科。

3.(玫瑰、海胆)刺:移除后,需注意预防真菌感染。

4. 鱼钩:由于倒钩的存在易导致二次损伤,需格外注意。首先消毒、局麻或全麻,可以顺着鱼钩刺入的方向,将鱼钩刺出皮肤外,然后切断倒钩端,再取出鱼钩,或用线或注射器针头协助移除鱼钩。

皮肤异物的治疗具体手段以及治疗过程中的注意事项还有哪些?本期丁香公开课,丁香园特邀到马里兰大学医学院附属医院急诊科医生助理 Bryan Fagan 与大家分享《皮肤异物》。

更多精彩内容请点击此处观看丁香公开课全部课程。

Bryan I. Fagan

丁香诊所 急诊科

Bryan I. Fagan,马里兰大学医学院附属医院急诊科医生助理(PA)、PA学校带教老师。

EDUCATION:
2002-2004 Bachelor of Science, University of Nebraska, College of Medicine-Interservice Physician Assistant Program (U.S. Army)
1996-1997 Associate of Science, George Washington University, Health Laboratory Sciences

EMPLOYMENT:
2013-present: Physician Assistant/US Army Maryland National Guard officer (65D) Care and treatment of military personnel.
2010-present: Physician Assistant, Bel Air Center for Plastic and Hand Surgery/Ramon A. de Jesus, MD, LLC; evaluation and treatment of patients with upper extremity problems/trauma and plastic/reconstructive needs.
2004-present: Physician Assistant, Dept. of Emergency Medicine, Upper Chesapeake Health System- under the direction of the attending physician, assessment and treatment of acute illnesses and injuries in the urgent care and main emergency department. I have been the Lead PA/Director of MLPs since 2012.
1995-2006: US Army Reserve, (Honorable Discharge 02/16/2006) Team member in US Army Medical Department NCO and Commisioned Officer
1998-2004: Medical Laboratory Technician, Johns Hopkins Hospital processing and evaluation of routine and STAT clinical medical specimens in microbiology, virology, hematology, immunology, and clinical chemistry.

CERTIFICATIONS and LICENSES:
Physician Assistant-Certified, NCCPA (recertified 11/2010)
Maryland State License
Maryland CDS
National DEA
BLS
ACLS
PALS
ATLS trained

MEMBERSHIPS:
American Academy of Physician Assistants

COMMITTEES:
Allied Health Review Committee
Meditech (hospital interface) introduction team Forerun and Dragon (voice -recognition EMR) introduction team
Clinical preceptor to PA students from Towson/CCBC and Anne Arundel Community College PA programs
Department peer review team
High Risk Patient management team
Emergency Department leadership

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