Save the hippy-dippy chamomile-mint-saffron teabags for your favorite ortho consult.

Sugar-glazed glans

Paraphimosis involves venous congestion and edema of a retracted foreskin, making it impossible for the patient to reduce it to the normal anatomic position. Immediate action is required if there are signs of acute ischemia to the glans.

Manual reduction or slitting of the foreskin are two common techniques of emergency reduction, both of which are painful and traumatic to the patient. If there are no signs of active ischemia, a slower but more humane technique involves using granulated sugar to draw out edema from the foreskin through osmotic action.1

Your local break room probably contains many packets of granulated sugar from prior coffee runs. Empty a few packets onto the patient’s foreskin (introduce yourself first) and pour some into the finger of a rubber glove, ultrasound probe cover, or even a regular condom.

Place this embarrassing contraption over the penis so the entire glans and foreskin is in direct contact with sugar, and then wait (Fig. 3).

Osmosis is slow, and the “no-peeking rule” applies here. Leave everything in place for 2 hours. Once you remove the penile cover, you should see a significant improvement in the edema, and the patient may even be able to reduce the foreskin himself.

If the foreskin can’t be reduced at this point, allow the osmosis process to continue a little longer before trying again.

It may keep him in the department longer, but most men will happily spend the extra time to avoid afflicting their tormented members with needles, scalpels, or huge amounts of brute force.

I do not know if Splenda, Equal, or Sweet’N Low is effective or safe, although it stands to reason that any dry powder might work as a desiccant. Somehow salt sounds like a bad idea.

Cup ‘n cap

It might be impossible for hospital management to stock your department with exotic items like tape and lidocaine, but everyone has one of those fancy Keurig automatic coffee machines!

When you aren’t having a sincere esteem-building chat with a co-worker over a misty mug of Mocha Mirage, you can actually use Keurig automatic coffee cartridges (K-Cups) for patient care.

Scalp veins are excellent candidates for intravenous catheter placement in chubby infants. Some references suggest taping a paper cup over scalp IV sites to prevent displacement, but these are too flimsy and can easily be crumpled. K-Cups are the perfect size and strength to create a protective “Fez” to keep that IV you fought so hard for safe and sound.