# 262 Upper Extremity Injuries
Most of everything that we do is with our hands. Naturally, the unarmored tissues are easily injured. When we have repaired the injury for best healing, it is not enough to grandly say to the patient, if in presence of a spouse, "Keep it dry. You are excused from doing the dishes!"
Realistically, household roles don't switch very much, yet income must be earned, food prepared and the dishes washed, children cared for, personal bathing must be done, the house kept, etc. "Time off work" may be used up, unavailable, or non-existent. Exigencies and practicality may intrude upon 'wound rest'.
Ask about patient responsibilities for others or work. Is task modification even possible? Is there a risk of immersing the injury dressings? Do the dressings put them at risk for being caught in machinery?
If there's considerable pain, consider lidocaine patches for opioid-sparing.
Before leaving the ED, provide some gloves until the patient can get them from a store or online. Consider waterproof dressings, membrane dressings, or wound sealants that may be applicable.
If casted with plaster or fiberglass, provide a sling for rest and encourage elevation. Having nurses or PT/OT available may enhance the teaching. "Shower sleeves" should be available to protect during bathing. Remind about the awkwardness of being off-balance with risk of falls or dropping kids and packages. Provide an estimate of weight restriction in lifting or carrying. Rotational tasks (keys in doorknob) may be awkward, too. Driving may be impaired also. Added caution in circumstances of potential danger (parking lots, shopping zones), those who are injured or encumbered are especially targeted by criminals for robbery or assault.
All Tips: 2013 2014 2015 2016 2017 2018 - Updated! (5/20/218)
