Urgent and Emergency Care
1 Local Anesthesia Administration 3
2 Field Block Anesthesia 9
3 Digital Nerve Block Anesthesia 15
4 Procedural (Conscious) Sedation 21
5 Arterial Puncture and Line Placement 27
6 Central Venous Catheter Placement 33
7 Pulmonary Artery Catheter Placement 43
8 Chest Tube Insertion 51
9 Percutaneous Cricothyrotomy 60
10 Incision and Drainage of Abscesses 66
11 Lumbar Puncture 72
12 Bone Marrow Biopsy 80
13 Cardioversion 88
14 Shoulder Reduction 94
15 Exercise Treadmill Testing 100
16 Fishhook Removal 109
17 Endotracheal Intubation 114
18 Mandibular Dislocation Reduction 129
19 Office Spirometry 133
20 Radial Head Subluxation (Nursemaid's Elbow) Reduction 139
21 Ring Removal 144
22 Thoracentesis 149
23 Tick Removal 159
Dermatology
24 Cryosurgery of the Skin 165
25 Keloid and Hypertrophic Scar Treatment 175
26 Earlobe Keloid Excision 181
27 Punch Biopsy of the Skin 187
Aesthetic Procedures
28 Aesthetic Procedures Introduction 195
29 Botulinum Toxin Type A for Facial Rejuvenation 200
30 Dermal Fillers for Facial Rejuvenation 214
31 Laser Hair Removal 234
32 Laser Photo Rejuvenation 249
33 Microdermabrasion 265
34 Radiosurgical Skin Surgery (LEEP) 278
35 Sclerotherapy 285
Suture Techniques
36 Basic Instrument Suture Tie 299
37 Deep Buried Dermal Suture 304
38 Simple Interrupted Suture 309
39 Corner Suture 316
40 Horizontal Mattress Suture 322
41 Running Cutaneous Suture 329
42 Running Subcuticular (Intracutaneous) Suture 334
43 Vertical Mattress Suture Placement 341
Skin Surgery
44 Skin Surgery Layout of Skin Procedures 349
45 Advancement Flaps 355
46 Burow Triangle (DogEar) Repair 361
47 Epidermal Cyst Excision 366
48 Epidermal Cysts: Minimal Excisional Removal 371
49 Fusiform Excision 378
50 Lipoma Excision 386
51 O-to-Z-plasty 394
52 Purse-String Suture Closure 400
53 Rhomboid Flap 406
54 Rotation Flap 413
55 Scalp Repair Techniques 419
56 Skin Tag Removal 427
57 Shave Biopsy 432
58 Tangential Laceration Repair 438
59 T-plasty 444
60 V-to-Y-plasty 450
61 Z-plasty 457
Nail Procedures
62 Digital Mucous Cyst Removal 465
63 Nail Avulsion and Matrixectomy 470
64 Nail Plate and Nail Bed Biopsy 476
65 Subungual Hematoma Drainage 484
66 Paronychia Surgery 489
Gynecology and Urology
67 Bartholin Gland Cyst and Abscess Treatment 497
68 Cold Knife Conization of the Uterine Cervix 504
69 Cervical Polyp Removal 509
70 Endometrial Biopsy 514
71 Colposcopy and Directed Cervical Biopsy 520
72 Fitting Contraceptive Diaphragms 534
73 Cervical Cryotherapy 539
74 Dilation and Curettage (D&C) 549
75 Hysteroscopic Female Sterilization with Microinsert (Essure) 557
76 Treatment of Noncervical Human Papillomavirus Genital Infections 566
77 Fine-Needle Aspiration of the Breast 581
78 Implanon (Etonogestrel Implant) 589
79 Intrauterine Device Insertion and Removal 598
80 Loop Electrosurgical Excisional Procedure 607
81 Office Hysteroscopy 618
82 Paracervical Block Anesthesia 627
83 Pessaries 633
84 No-Scalpel Vasectomy 648
85 Laparoscopic Tubal Cauterization 655
Gastroenterology
86 Abdominal Paracentesis 663
87 Anoscopy with or without Biopsy 669
88 Anal Cytology and High-Resolution Anoscopy 676
89 Colonoscopy 689
90 Esophagogastrod uodenoscopy 699
91 Flexible Sigmoidoscopy 713
92 Treatment of Internal Hemorrhoids 723
93 Pilonidal Cyst or Abscess Management 731
94 Excision of Thrombosed External Hemorrhoids 737
Eye, Ear, Nose, and Throat Procedures
95 Anterior Epistaxis Treatment 745
96 Cerumen Impaction Removal 753
97 Chalazia Removal 762
98 Conjunctival and Corneal Foreign Object Removal 768
99 Flexible Fiber-Optic Nasolaryngoscopy 775
100 Foreign Body Removal from the Nose and the Ear 782
101 Tympanometry 787
Musculoskeletal Procedures
102 Carpal Tunnel Syndrome Injection 793
103 De Quervain's Injection 799
104 Extensor Tendon Injury Repair 803
105 Greater Trochanteric Bursa Injection 811
106 Knee Joint Aspiration and Injection 816
107 Olecranon Bursa Aspiration and Injection 824
108 Plantar Fascia Injection 828
109 Shoulder Injection 834
110 The Short Arm Cast 840
111 The Short Leg Cast 850
112 Lower Extremity Splinting 860
113 Upper Extremity Short Arm Splinting 870
114 Long Arm Splinting 882
115 Trigger Finger Injection 893
116 Trigger Point Injection 898
117 Wrist Ganglia Aspiration and Injection 904
Pediatrics
118 Circumcision using Gomco Clamp and Dorsal Penile Block 911
119 Circumcision using the Mogen Clamp 920
120 Circumcision using the Plastibell Device 926
121 Intraosseous Line Placement 932
122 Pediatric Sedation 936
123 Suprapubic Bladder Catheterization 944
Appendix A Informed Consent 947
Appendix B Lines of Least Skin Tension (Langer Lines) 948
Appendix C Bacterial Endocarditis Prevention Recommendations 949
Appendix D Recommended Margins for Removal of Neoplastic Skin Lesions 951
Appendix E Skin Preparation Recommendations 953
Appendix F Suggested Anesthesia Tray for Administration of Local Anesthesia and Blocks 955
Appendix G Instruments and Materials in the Office Surgery Tray 956
Appendix H Instruments and Materials in a Standard Gynecologic Tray 957
Appendix I Suggested Tray for Aspiration and Injection Procedures 958
Appendix J Recommended Suture Removal Times 959
Appendix K Recommendations for Endoscope Disinfection 960
Index 963