Katz School PA student Carin Gannon demonstrates a type of suturing technique, called the interrupted stitch, at St. John's Episcopal Hospital under the supervision of Abraham Oxilas, a clinical assistant professor and Gannon鈥檚 supervisor. photos by Denton Field.By Dave DeFusco
Two weeks into a clinical rotation in the emergency department at St. John鈥檚 Episcopal Hospital in Far Rockaway, Queens, Carin Gannon, a student in the Katz School鈥檚 M.S. in Physician Assistant Studies, was put to the test. A local man gashed his leg on a piece of glass and was rushed into the emergency department bleeding profusely.
After being x-rayed to make sure that the glass wasn鈥檛 embedded in the wound, he was wheeled back into the emergency department where Gannon and Abraham Oxilas, a Katz School clinical assistant professor and Gannon鈥檚 supervisor at St. John鈥檚, were waiting. It had been two hours since the injury, so Gannon knew that it hadn鈥檛 started healing from within, but it had been several months since she had practiced suturing in Oxilas鈥 course Clinical Skills and Procedures.
Seeing yellowish subcutaneous fatty tissue, she washed her hands with soap, put on a pair of sterile gloves and grabbed a suturing kit. She squeezed sterile water into the wound and injected lidocaine seven times under the skin to numb the area. Oxilas sewed the first stitch and then handed the needle to Gannon.
Gannon demonstrates the interrupted stitch technique, where each stitch is tied off using a surgeon's knot.Under the watchful eye of Oxilas and the patient, Gannon went to work. 鈥淚 knew how to do it from working on a silicone model in class,鈥 she said, 鈥渂ut I didn鈥檛 want to let on that this was my first time suturing a live patient, so I was like, 鈥極kay, I gotta jump in and do the best I can.鈥 I had the confidence. I just had to summon the muscle memory.鈥
She took the suturing needle, shaped like a crescent moon, and held the two sides of the wound while she stitched. Like needlework, suturing can involve a variety of techniques. Gannon used a method called the interrupted stitch, where each stitch is tied off using a surgeon鈥檚 knot. She pulled the knots tight enough to hold the two sides of the wound firmly together without squishing them up into a tent shape. Most simple lacerations can be sewed in less than 10 minutes but because the man needed seven stitches, it took Gannon a half hour to finish closing the wound.
鈥淚t looked better than the way I practiced it in class,鈥 she said. 鈥淚 know it鈥檚 one of those small things that PAs do every day but when it鈥檚 your first time doing it, it鈥檚 very exciting to be able to perform those skills.鈥
Gannon instructed the grateful patient to keep an eye out for signs of infection, like redness streaking up or down his leg, and to avoid using alcohol or hydrogen peroxide to clean the wound. He was given a tetanus shot and went home with antibiotics.
鈥淐arin is very personable, knowledgeable and quick to adapt to her environment,鈥 said Oxilas. 鈥淗er prior hospital experiences have helped her thrive in the emergency room in her very first rotation and I couldn鈥檛 be more proud of her.鈥
Gannon does three 12-hour shifts a week, taking the subway at 3:30 a.m. to Far Rockaway, a three-hour ride one way from the Bronx. On the way in, she listens to her favorite musicians, Hozier and Noah Kahan, and on the way home, she writes up her notes on patient diagnoses, tests, procedures and medications since it鈥檚 fresh in her mind.
At the end of her clinical rotation, she鈥檒l be tested in class on what she鈥檚 learned. Oxilas said the Katz School PA program is exceptional for its commitment to educating PAs to become culturally competent so they can provide appropriate treatment to diverse communities that are lacking adequate health care.
鈥淥ur students enthusiastically help patients in any way they can, whether it be coming up with differential diagnoses, creating treatment plans, performing therapeutic and diagnostic procedures, or completing even simple tasks such as grabbing a blanket for a patient,鈥 he said.
Gannon said the Katz School PA program has taught her to think holistically about patient care鈥攖he physical, psychological, emotional and spiritual dimensions of care that lead to recovery. Scheduled to graduate in December 2024, she鈥檚 excited for the next clinical rotation where she鈥檒l be exposed to the demands of another discipline, such as endocrinology or pediatrics. She wants to experience a range of disciplines before she makes a career decision but at least for now, her heart seems intent on emergency care.
鈥淲orking in the emergency department and seeing the role that PAs play is inspiring,鈥 said Gannon. 鈥淚 really love critical care and I like interacting with trauma patients in the inner city. Six years in the emergency department is like 20 years in any other department. It has everything.鈥
