 | Minor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.) |
 |  | (introduction...) |
| | Notice |
|  | Chapter 1: Wounds - Burns |
| | Dressings |
| | Wounds |
| | Burns |
| | Chapter 2: Infection of soft tissues |
| | Abscess |
| | Treatment of tropical myositis |
| | Infections of the hand and fingers |
| | Chapter 3: Catheterisation and drainage |
| | Catheterisation of large veins |
| | Lumbar puncture |
| | Pleural puncture |
| | Thoracic drainage |
| | Pericardial puncture |
| | Drainage of ascites and intra-peritoneal perfusion |
| | Puncture and drainage of the knee |
| | Chapter 4: ent procedures |
| | Epistaxis |
| | Ear drainage |
| | Dental extraction |
| | Chapter 5: uro-genital procedures |
| | Urinary catheterisation |
| | Reduction of a paraphymosis |
| | Episiotomy |
| | Suturing episiotomies or perineal tears |
| | Intra-uterine procedures |
| | Treatment of a bartholin abscess |
| | Chapter 6: treatment of trauma |
| | Fractures and disIocations: the basics |
| | Shoulder and arm trauma |
| | Trauma of the lower limb |
| | Period of immobilization for major fractures |
| | Appendix |
| | List of essential supplies (absolutely necessary) |
| | Disinfection and Sterilization of medical equipment and supplies |
| | Bibliography |
Ear drainage
Incision of the tympanic membrane.
Indication
Acute otitis with fever, intense pain, and an inflamed distended non-perforated tympanic membrane.
Material
Drainage needle
Otoscope with a light or a speculum with a head-light.
Technique
Figures 71, 72
While viewing the membrane, and without anesthesia, make a radial incision in the posterior-inferior quadrant with a stylet or a special lancet.
Aspirate the pus with a soft catheter, gently removing the serous fluid and pack gently with cotton.
Antibiotic therapy
Systemic:
Ampicillin if less then 5 years of age: 100 mg/kg/day PO x 3 -10 days
Phenoxymethyl penicillin / Penicillin V older than 5 years of age:
Adult : 3 x 2 tablets/day (tablets of 400.000 U)
Child : 50
to 100.000 U/kg/day x 5 to 10 days, or procaine penicillin or PPF
FIGURE
100.000 U/kg/day x 3 days, followed by penicillin V during 4 to 6 days.
Erythromycine for those allergic to betalactamines:
Adult : 1 g in 3 divided doses/day x 10 days
Child : 50
mg/kg/day in 3 divided doses/day x 10
days
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