EM Cases · Wound assessment and management
Hand laceration assessment and management — the procedural station
An ACEM Fellowship OSCE clinical management station. Tests the structured wound assessment (MEAT — mechanism, neurovascular, tendon, depth, contamination, foreign body, age, host), the documented pre-anaesthesia neurovascular and tendon check, the irrigation standard, the tetanus prophylaxis decision, the closure decision, and the safety-netting counselling. Maps to the OSCE clinical management and procedural domains. ACEM-primary, globally tagged.
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Station brief
Format. Clinical management / procedural station, 11 minutes total — 3 minutes reading, 8 minutes active assessment and management with a role-player and a wound-model arm. You are the Emergency Medicine consultant. The actor plays the patient, Mark, a 40-year-old builder.
Candidate instructions. Mark cut his dominant right index finger on a rusty metal sheet at a building site 3 hours ago. Examine the wound, deliver the appropriate management, and counsel him for discharge. The examiner assesses your clinical assessment, your procedural decision-making, and your communication.[1]
References3ShowHide
- [1]Weiss EA, Oldham G, Lin M, Foster E, Quinn JV. Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing. BMJ Open, 2013.PMID 23325896
- [3]Hollander JE, Singer AJ, Valentine SM, Shofer FS. Risk factors for infection in patients with traumatic lacerations. Academic Emergency Medicine, 2001.PMID 11435186
- [6]Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H. Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the ACIP — United States, 2019. MMWR Morbidity and Mortality Weekly Report, 2020.PMID 31971933