i'll preface this by saying we had not even begun to drink yet.
this past saturday i went to my buddy's house to watch him change a sensor on his mazda and help him continue to strip an s10 that we will be cutting up for scrap. he's lying on his back taking out some fender bolts on the passenger side, while i've got my back to him, working on removing bolts from the driver's side.
the next thing i hear is "dude, i think i need stitches". i heard no bang, no swearing, nothing. without turning to look at him, i head into the garage for a socket and reply "nah, you're fine." that's when i turned around, looked at him and said "yeah. you probably need stitches." he's got his hand on his head, and a waterfall of blood pouring down his face.
you would think we had done this before. there was zero sense of urgency. i walked over and grabbed him a wad of paper towels "here, put this on your head. let's put all the tools in the garage, lock up, and head to the er (maybe 1.5 miles away).
we arrived at the er in good spirits, laughing and joking the entire time. we check him in and get to commenting on the variety of others also in the waiting room. at this point, a nurse came with some gauze to swap in for the bloody paper towels. this is when i finally got a good look at the gash
it had pretty much stopped bleeding, so my concern shifted to what was happening in the background. wtf
idk if that's the dude's mom or what. mark says it looks like the cub is trying to creep on a passed out silver cougar. then you have mr. fitted cap. as far as i could tell, he was there by himself.
a few minutes later, a nurse comes back out, walks up to us, points at my friend and asks "chainsaw?" we laugh and tell her no. she walks off and finally lands on a guy clutching a bandaged up hand. ahhh, chainsaw. he follows her through some double doors and his buddy walks by us heading for the exit, laughing pretty hard. of course we stopped him for the story:
"i just pulled in my driveway and my neighbor calls me over.
-hey johnny! check it out, i got it idling nice. watch.
rev, rev. he went to cut a branch, and it kicked back and caught his hand. hahahahaha. i got it all on video."
he didn't show us the video. bastard.
another nurse comes out and walks up to the security desk. "can you help me out with a patient. he's drunk and threatening to get violent if he doesn't get his meds. i want him out of here." the guard stands up and he's shorter than i am. those of you who have met me know that i would more likely be cast as andre the giant's d!ck in a biopic than napolean. she looks him up and down and asks "is there anyone else you could bring with you?" he wasn't too thrilled. not with her request, but with the two ***holes dying with laughter.
we finally get brought into a room where they gave my friend a precautionary tetanus shot since he couldn't remember if he go one during his last doctor visit. during one of our waiting periods, we agreed that aids or ebola jokes would probably not be received well. we went about, checking out nurses until the doctor finally made it in. he wouldn't let me record the procedure, but in the end, my friend ended up with 7 staples.
afterwards, we went back to his house, kicked a keg, and finished stripping the front end of the s10. oh, and we watched a video on how to remove staples from a scalp at home
i slept through those last 7 years of med school.
While technically, all of that should have been performed in a sterile environment, I've done enough redneck ER procedures to know that it isn't always necessary. FWIW, Yes, the area around a wound should be shaved before placing staples. It helps ensure proper placement. If a patient is in surgery, this happens anyway. Whether or not this happens in an ER depends on the work load and the motivation of the ER doctor / PA.