Instead of involving the parent when suturing a child, I include the child whenever possible. After first explaining that we need to add medicine to make him or her more comfortable (1% lidocaine diluted with sodium bicarbonate in a 10:1 ratio), I then help the child put on sterile gloves and hand over the scissors.

When I am done tying, the child gets to cut the sutures. The kids seem to love being involved, and it helps them get past the stick of the needle (which is usually far less painful than they imagined).— Douglas Kautz, PA-C, Rochester, Minn.

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

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