EMERGENCIES

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What to do in an emergency ?

Disinfect

Immediately disinfect the wound with an antiseptic.

Put on a bandage

Put a bandage on to stop the bleeding;

Call

Call a hand emergency service, the risk of going to a hospital that does not have a hand surgeon is to wait because it is not a priority and then be readdressed the next day to a structure with hand emergencies.

Prepare

Prepare your vaccination status, allergy and medication list. Start young (without drinking or smoking).

If you are waiting, we recommend that you bring a book or your phone charger without any valuable personal belongings.

What to do in case of complete amputation?

In the event of complete amputation, immediately call the CMPM or 15 to benefit from surgical treatment as quickly as possible.

Keep the severed part and place it in a plastic bag. Immerse this bag in a plastic or insulated bag containingice.Without direct contact between the severed part and ice cream.

Thererelocation : depending on the level of section, the finger concerned, the patient's history, digital reimplantation is not always possible. It is in the operating room during the assessment of the affected structures that thefinal decision is taken or not reestablish or regularize the finger.
Reimplantation is an operation whoseThe outcome is uncertain and will require amonitoring in a hospital environment to ensure good vascularization of the replanted fingers.

I have a paronychia, should I have an operation?

The management of whitlows has evolved enormously.
In case of inflammatory phase without collection medical treatment is recommended by antiseptic baths.

In the event of unfavorable development or collected phase, then a surgical intervention is necessary.
The evacuation of the collection and the search for germs is essential so as not to overlook atypical germs, it is then necessary to carry out the excision of the infected tissues.

In the absence of treatment the evolution of whitlow goes towards theduct phlegmon or arthritis.
In the event of comorbidity (diabetes, heart disease, history of infection) this can promote the spread of the infection.

In the event of active whitlow, never take an anti-inflammatory for self-medication.

The Patient Journey

Switch to the SNP

Initial evaluation by the doctor of unscheduled emergencies, clinical evaluation, preoperative assessment, ECG if necessary, biology if necessary, additional imaging.

Outpatient service: Fast-Track

Once assessed, if the surgical indication is accepted, the patient prepares for admission and then is admitted to the dedicated outpatient department for hand surgery.

Most patients are eligible for outpatient care and travel "standing" accompanied by a stretcher bearer during their travels.

Operating Room

Several stages follow one another in the operating room:

- arrival at the operating room at the ALR induction post:

installation of a venous catheter, meeting with the anesthesia team, performance of loco-regional anesthesia under ultrasound for most cases.

- installation in the operating room: this is often the first contact with your surgeon, who will re-examine you and re-examine additional examinations.

At the same time, the paramedical team will install you, put in place the tourniquet and the monitoring elements.

Depending on the severity, interventions can last from a few minutes to several hours.

At the end of the procedure, the surgeon explains the seriousness of the lesions and the post-operative care protocol.

- recovery room: aAfter the procedure, a short visit to the recovery room allows the anesthesia team to ensure the absence of pain and monitors the various vital parameters.

Return to the Ambulatory Surgery Department

Back in the ward, a final check is made of your vital parameters, the dressing is inspected and your prescriptions are handed out.

A snack is offered to you before your departure.
It is customary to have a companion for the return of the ALR immobilizing the arm concerned for several hours.

After surgery

Return home

Loco-Regional Anesthesia (LRA) can immobilize and numb the arm for several hours and can be a source of concern.
The pain is subsequently controlled by prescribed analgesic medications as well as icing.
In the event of a fracture of the upper limb, we also recommend elevating the limb (on a cushion for example) when sitting or lying down.

The dressings are then made by the home nurse.

Call the next day

As part of the quality process, the day after the procedure, a nurse from the outpatient surgery department will call you back to ensure that no adverse events have occurred in the evening.

Post-operative appointment

Depending on the condition, one or more post-operative appointments will be made with your operator. These are most often short appointments, which allow a re-explanation of the condition, a check of the scar and mobility, the provision of information concerning the germs found. Sometimes a control x-ray is requested before the consultation.