Top 5 Finger Complaints in Emergency Care-Top 5 Finger Complaints in Emergency Care

Video Transcription

Video Summary

This presentation reviews the top five finger complaints encountered in emergency care, focusing on diagnosis, clinical signs, management, and important care considerations. The speaker, an emergency and flight nurse practitioner and nursing professor, emphasizes thorough hand and digit assessment, including neurovascular status and tendon function (flexor superficialis and profundus), and appropriate use of diagnostics like ultrasound with water bath technique. <br /><br />Key conditions covered include:<br /><br />1. Flexor tenosynovitis—a surgical emergency characterized by uniform finger swelling, severe pain on extension, and resting flexion; requires urgent orthopedic/hand surgeon intervention and broad-spectrum antibiotics due to risk of serious complications.<br /><br />2. Paronychia—an infection around the nail from trauma or nail biting; treated with warm soaks, possible incision and drainage (I&D), and antibiotics targeting skin flora and MRSA as needed.<br /><br />3. Felon—an abscess in the fingertip pad often from puncture wounds; requires I&D, pain control via digital block, culture, antibiotics, and follow-up.<br /><br />4. Subungual hematoma—blood under the nail from crush injury; treated by nail trepanation for immediate pain relief, sometimes with x-rays to rule out fracture.<br /><br />5. Herpetic Whitlow—a viral HSV infection with vesicles and pain; treated with antivirals, never incised due to risk of viral spread.<br /><br />Additional topics include tetanus prophylaxis for contaminated wounds, management of mammal bites with amoxicillin-clavulanate, rabies risk and post-exposure prophylaxis, digital blocks (techniques and anesthesia options), and ring removal methods. The key "do not miss" diagnosis is flexor tenosynovitis that mandates prompt surgical care to avoid loss of function.

Keywords

flexor tenosynovitis

paronychia

felon

subungual hematoma

herpetic whitlow

digital block

emergency finger injuries