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Suturing is one of the most important skills to learn as a nurse practitioner, because patients expect the clinician to perform simple wound closure in primary care settings. Having a positive attitude and lots of practice will build the confidence you require for this skill. A solid knowledge of anesthetics and types of wound closure is necessary. Suturing techniques include simple interrupted, running sutures, horizontal and vertical mattress sutures which can be used depending on the type of wound closure. Review some of the skills in our workshop.

Epistaxis Management

Epistaxis is a common emergency in the primary care setting. Up to 60% of adults in the U.S., have experienced epistaxis. Two types of epistaxis include anterior and posterior bleed. A large number of cases of anterior epistaxis occurs as a result of the rich blood supply of the Kiesselbach Plexus, local irritation due to disruption of the nasal mucosa from trauma, infectious process, foreign body, allergic reaction, dry nasal mucosa, prolonged use of anti-platelets and long-term cocaine use. Posterior epistaxis occurs from the internal maxillary, sphenopalatine, and descending palatine arteries. Anterior bleed is more common and less severe than posterior bleed. Management of epistaxis include use of compression therapy, directive and packing.