Very few doctors know how to properly numb an abscess for an I&D procedure. There is an ER doc on YouTube that has a channel called PROCEDURETTES. It is directed at other MD’s and dedicated to humane and compassionate patient care.

The doc has a lot of great ones, with his ABSCESS SUCCESS tutorial being outstanding. In it he demonstrates how to make the procedure FAR less painful for the patient by:

*covering the abscess with EMLA cream prior to injecting. EMLA is a very strong numbing paste and can be used with some surgical procedures.

*buffeting the lidocaine with sodium bicarbonate to take the sting out

*warming the syringes in water or with a warm wet towel

*using teeeeny little needles initially before graduating to a larger one for deeper numbing.

All this takes is a bit more time; the supplies should be in any ER. The problem is few docs take the time. Even in the ER they can manage their time if they are inclined to: the tutorial suggests that while the EMLA cream works they can use that time to check on other patients, look at labs, etc.

Another huge concern is that doctors often can’t clean the wound out properly with the patient howling in tortured agony. Also, many patients are terrified of returning after the first ordeal for any follow up care. So the infection may not be cleaned out properly

Here is the info on this vid:
For medical professionals only. This Procedurette describes ways to reduce the pain of incision & drainage of cutaneous abscesses when using local anesthesia. The initial injections of an abscess can be horrendously painful, and while the method shown here takes a little longer, let’s face it: we’re supposed to reduce agony. I have avoided a lot of procedural sedations with these tricks, so give ‘em a try the next time you’ve got a patient with an especially low pain tolerance. Also shown is an alternative to gauze packing.

Do a search on PROCEDURETTES and check out his other vids. He is hilarious and absolutely dedicated to compassionate patient care.

I have an enormous pet peeve on inept care and torturing patients from apathy, ignorance or both.

Peace, Jiffy