Trick of the Trade: Making a beanie hat

Scalp lacerations are a common condition in the Emergency Department. Some require no bandage over once the injury is repaired. Because the scalp is so vascular, others require a pressure dressing over the site to minimize hematoma formation.

How do you bandage these patients? It is difficult to secure any wrap or square gauze over the site, because the head is round and the hair is slippery.

Trick of the Trade:
Make a snug-fitting beanie hat using tubular gauze.

• Find the appropriate size tubular gauze. It should fit snuggly over the patient's head when fully stretched open. Start with a 1-foot long piece of tubular gauze. Tie a knot on one end. This will sit at the vertex of the patient's scalp.

• Create 2 tails by cutting longitudinally along the tubular gauze.

• Pull the tubular gauze over the patient's scalp. Usually patients won't look this giddy-happy during this process.

• Secure the two tails under the patient's chin.

This technique allows you to rest several layers of 4x4 inch gauze over the laceration site as pressure dressing. The tubular gauze stabilizes it in place without any tape.

Thanks to Dr. Eric Silman (UCSF-SFGH EM chief resident) for the idea and photos!