Laceration: History and Physical
After the initial assessment of ABCDE and vital signs, determine the timing of the injury, mechanism of the injury, and tetanus immunization status.
- If there is any concern for non-accidental trauma, see Child Physical Abuse Clinical Pathway
- If there is any concern for foreign body, consider imaging.
- A laceration can be associated with a more serious underlying injury. Consider the possibility of additional injury based on the location.
|
Location of Laceration |
Underlying Injury to Consider |
|
Head/Face/Neck |
Intracranial injury Concussion (see Concussion Clinical Pathway) Neck injury |
|
Extremity |
Fracture Ligament or tendon injury |
|
Eye |
Ruptured globe Nasolacrimal duct injury Orbital fracture *Eyelid margin involvement may require subspecialty evaluation |
|
Ear or Nose |
Cartilage injury |
|
Oral/Maxillofacial |
Maxillary fracture *Vermillion border involvement may require subspecialty evaluation |
|
Thoracic |
Pneumothorax |
|
Abdominal |
Intra-abdominal injury |
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.