Any suggestions for wound care in Manhattan?
February 27, 2022 3:21 PM Subscribe
A friend of mine suffered a kind of gruesome injury at work yesterday. He went to the ER and will be making an appointment with an orthopedist. In the meantime, he is too queasy and freaked out to change the dressing.
I tried to help him do it today, but I was also pretty queasy about it. Plus, he wouldn't let me tug on the part of the dressing that was clotted onto the wound. We had to wrap him back up on top of that. He needs someone who knows what to do and can do it even if he's freaking out. I'm going to take him to urgent care tomorrow, but he's had very bad experiences at the City MD-type places. Are there better urgent care options than the chains? Should we try to hire a nurse?
I would welcome specific suggestions for nursing options, good urgent care locations, or another ideas if you have them.
I tried to help him do it today, but I was also pretty queasy about it. Plus, he wouldn't let me tug on the part of the dressing that was clotted onto the wound. We had to wrap him back up on top of that. He needs someone who knows what to do and can do it even if he's freaking out. I'm going to take him to urgent care tomorrow, but he's had very bad experiences at the City MD-type places. Are there better urgent care options than the chains? Should we try to hire a nurse?
I would welcome specific suggestions for nursing options, good urgent care locations, or another ideas if you have them.
Wound care home visits by nursing can be prescribed / ordered by the doctor's office for home health care since this is something that he can't take care of and does not have someone to take care of for him.
posted by RoadScholar at 4:57 PM on February 27, 2022 [1 favorite]
posted by RoadScholar at 4:57 PM on February 27, 2022 [1 favorite]
Definitely seek professional help if your friend is unable to do it by himself.
Wound care is a serious topic. Professor Dan Ariely, who had once suffered burns over 70% of his body due to an explosion, was in a burn center for a LONG time, and suffered through many bandage changes, which got him to study how a burn patient perceives pain, using himself as subject. His alternate introduction to his first book goes over the experience, and his MIT paper goes into it in more detail, which may help you and your friend formulate a strategy to cope with his pain and treatment.
posted by kschang at 5:44 PM on February 27, 2022 [3 favorites]
Wound care is a serious topic. Professor Dan Ariely, who had once suffered burns over 70% of his body due to an explosion, was in a burn center for a LONG time, and suffered through many bandage changes, which got him to study how a burn patient perceives pain, using himself as subject. His alternate introduction to his first book goes over the experience, and his MIT paper goes into it in more detail, which may help you and your friend formulate a strategy to cope with his pain and treatment.
posted by kschang at 5:44 PM on February 27, 2022 [3 favorites]
Best answer: I had an injury that required redressing the wound every other day for a few weeks, and I wasn't able to do it myself. I ended up going to a walk-in clinic that was part of a hospital and they did it for me. If your friend wants something a step up from a clinic chain, that might be a good option for them, too.
posted by NotMyselfRightNow at 6:06 PM on February 27, 2022 [4 favorites]
posted by NotMyselfRightNow at 6:06 PM on February 27, 2022 [4 favorites]
Best answer: I hope the hospital gave him specific wound care instructions and hopefully some supplies. Did they tell him to change the dressing every day or is this something he assumes needs to be done daily?
Without knowing his specific injury I can't make specific suggestions about dressing changes, but in general when doing wound care and dressing changes as a nurse you should set up a clean area and wash your hands. With a bleeding wound that has dried or nearly-dried bloody gauze, it is helpful to wet the gauze thoroughly with sterile saline (sold in liters at pharmacies) for a few minutes to let the dried blood soften a bit before removing the dressing - just let it drip onto the dressing from the bottle and wait a few minutes to soften the dried blood. (Don't use water and never Hydrogen peroxide; contrary to what your mother may have told you, hydrogen peroxide is much too damaging to cells and will impair healing.) That will make pulling the gauze away from the wound easier and less traumatic to the tissue, though if the gauze was saturated with blood it might still pull and bleed. Be gentle and do this slowly to reduce tissue trauma and pain. Also, it might be helpful to know that a little bleeding is not a bad sign - it's a good sign that the area is receiving a brisk blood supply to promote healing.
I agree that a visiting nurse might be a wise idea if the wound is large. Your friend should call his insurance company, especially if they have a nurse line, for advice about having a professional wound care nurse appointment at home if he is not able to make an office visit. It might also be possible to go to an urgent care clinic, especially if it starts to look infected or if he has a fever. If he was given antibiotics at the ER he should take them all for the entire duration of the prescription.
posted by citygirl at 6:14 PM on February 27, 2022 [5 favorites]
Without knowing his specific injury I can't make specific suggestions about dressing changes, but in general when doing wound care and dressing changes as a nurse you should set up a clean area and wash your hands. With a bleeding wound that has dried or nearly-dried bloody gauze, it is helpful to wet the gauze thoroughly with sterile saline (sold in liters at pharmacies) for a few minutes to let the dried blood soften a bit before removing the dressing - just let it drip onto the dressing from the bottle and wait a few minutes to soften the dried blood. (Don't use water and never Hydrogen peroxide; contrary to what your mother may have told you, hydrogen peroxide is much too damaging to cells and will impair healing.) That will make pulling the gauze away from the wound easier and less traumatic to the tissue, though if the gauze was saturated with blood it might still pull and bleed. Be gentle and do this slowly to reduce tissue trauma and pain. Also, it might be helpful to know that a little bleeding is not a bad sign - it's a good sign that the area is receiving a brisk blood supply to promote healing.
I agree that a visiting nurse might be a wise idea if the wound is large. Your friend should call his insurance company, especially if they have a nurse line, for advice about having a professional wound care nurse appointment at home if he is not able to make an office visit. It might also be possible to go to an urgent care clinic, especially if it starts to look infected or if he has a fever. If he was given antibiotics at the ER he should take them all for the entire duration of the prescription.
posted by citygirl at 6:14 PM on February 27, 2022 [5 favorites]
Best answer: Oh no, I am so sorry to hear about this.
Since it is work-related, his Workers Comp case manager may be able to help with some resources of where to go. He should also keep them informed of any medical treatment he seeks on his own for this injury, along with keeping and submitting all paperwork through the proper channels. This will save everyone a lot of headaches later on. If his workplace has a dedicated Safety person, they should also be able to help him with this (point him in the right direction, not help change the bandages).
posted by Sparky Buttons at 7:29 PM on February 27, 2022 [2 favorites]
Since it is work-related, his Workers Comp case manager may be able to help with some resources of where to go. He should also keep them informed of any medical treatment he seeks on his own for this injury, along with keeping and submitting all paperwork through the proper channels. This will save everyone a lot of headaches later on. If his workplace has a dedicated Safety person, they should also be able to help him with this (point him in the right direction, not help change the bandages).
posted by Sparky Buttons at 7:29 PM on February 27, 2022 [2 favorites]
When my husband had open-heart surgery, our health insurance company sent visiting nurses to our house once or twice a week for a month and part of the visit was to look under the bandages at my husband's surgical incision and make sure it was healing correctly. They had medical bags with them so presumably had wound care supplies they could have used if necessary.
I suggest your friend reach out to their case managers at both the hospital they were seen at and the workers comp insurance company and ask for visiting nurse service. It is economically rational for the insurance company to want to pay for this as insurance companies' own research has found that visiting nurses save them a ton of money in hospital readmissions.
posted by Jacqueline at 10:26 PM on February 27, 2022 [1 favorite]
I suggest your friend reach out to their case managers at both the hospital they were seen at and the workers comp insurance company and ask for visiting nurse service. It is economically rational for the insurance company to want to pay for this as insurance companies' own research has found that visiting nurses save them a ton of money in hospital readmissions.
posted by Jacqueline at 10:26 PM on February 27, 2022 [1 favorite]
Response by poster: Thanks everyone. I hadn't thought about his insurance nurse line and didn't know workers comp had a case manager. He's doing the workers comp paperwork today and I'm going with him to a hospital-affiliated urgent care.
posted by Mavri at 5:57 AM on February 28, 2022 [4 favorites]
posted by Mavri at 5:57 AM on February 28, 2022 [4 favorites]
You should know that home health nursing is under the same kind of staffing crisis as so many other businesses -- unfortunately, this may mean that even if your friend's insurance/worker's comp approves home nurse visits, there may not be a nurse available to see him as frequently as he needs dressing changes.
That's a verbose way of saying "have a backup plan".
posted by shiny blue object at 6:47 AM on February 28, 2022 [2 favorites]
That's a verbose way of saying "have a backup plan".
posted by shiny blue object at 6:47 AM on February 28, 2022 [2 favorites]
Make sure bandages never feel too tight - sometimes wounds swell if you bump them. Too tight is actually urgent as it can cut circulation, so treat that as an emergency requiring an immediate dressing change.
posted by nouvelle-personne at 8:10 AM on February 28, 2022 [1 favorite]
posted by nouvelle-personne at 8:10 AM on February 28, 2022 [1 favorite]
he's had very bad experiences at the City MD-type places
I've had only good experiences there. My local is Riverdale/Kingsbridge on West 237th. YMMV apparently, but a corporate name doesn't dictate much about the individual doctors inside.
ETA: The East 86th CityMD, also, handled a serious injury for me in the right way (by promptly sending me to Weill-Cornell instead of trying to handle it in-house).
posted by JimN2TAW at 9:35 AM on February 28, 2022 [2 favorites]
I've had only good experiences there. My local is Riverdale/Kingsbridge on West 237th. YMMV apparently, but a corporate name doesn't dictate much about the individual doctors inside.
ETA: The East 86th CityMD, also, handled a serious injury for me in the right way (by promptly sending me to Weill-Cornell instead of trying to handle it in-house).
posted by JimN2TAW at 9:35 AM on February 28, 2022 [2 favorites]
« Older A light vegetarian lasagna without tomato sauce? | Ontario probate / wills / executor question Newer »
This thread is closed to new comments.
posted by meowzilla at 4:49 PM on February 27, 2022 [1 favorite]