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Modern Guide to Primary Care Procedures: Step-by-Step Techniques for Office, Urgent Care, and Ambulatory Practice Suturing, Skin Biopsy, Joint Injecti
Paperback
Publisher: Independently Published
Published: Jul 10 2026
Pages: 508
Weight: 2.57
Height: 1.02 Width: 8.50 Depth: 11.00
Language: English
The range of procedures expected in office and ambulatory practice has widened faster than most training has kept pace with. A clinician finishing residency today may place an intrauterine device, drain an abscess, biopsy a lesion, inject a shoulder, read a point-of-care ultrasound, and control a brisk nosebleed, often in the same session and often with no colleague nearby who does the same work. Modern Guide to Primary Care Procedures is written to prepare that clinician for the full breadth of contemporary practice.
The book is organized around a single discipline: a procedure is a decision before it is a technique. That principle becomes the Decide, Do, Defend framework applied in every chapter:
- Decide, the judgment before the instrument is picked up, including patient selection, indications, contraindications, and knowing when to refer rather than proceed
- Do, the clean and reproducible execution of the procedure in ordered, hazard-marked steps
- Defend, the documentation and follow-up that protect both patient continuity and clinician
Foundational chapters cover the skills nearly every procedure depends on, including patient safety, informed consent, sterile technique, procedural coding, and a full progression of anesthesia, from local and topical agents through field blocks, digital and peripheral nerve blocks, and procedural sedation.
From that base, the book spans the procedures a busy practice encounters:
- Emergency and airway skills, including intubation, cricothyroidotomy, chest tube insertion, cardioversion, lumbar puncture, abscess drainage, and joint reductions
- Point-of-care ultrasound as a dedicated skill, covering physics and knobology, E-FAST, soft tissue, DVT, vascular, and gynecologic and procedural guidance
- Vascular and thoracic access, including arterial and central lines and thoracentesis
- Dermatologic procedures, including dermoscopy, punch, shave and incisional biopsy, cryosurgery, keloid treatment, and aesthetic procedures
- Wound closure, from basic suturing through advanced mattress, subcuticular, and corner techniques, office skin surgery, excisions, local flaps, and plasty techniques
- Nail procedures, including avulsion, matrixectomy, biopsy, and subungual hematoma
- Gynecologic and reproductive procedures, including colposcopy, IUD insertion and removal, endometrial biopsy, office hysteroscopy, and LEEP
- Gastrointestinal, anorectal, ENT, ophthalmic, and thyroid procedures
- Joint aspiration and injection of the upper and lower extremity
- Pediatric procedures, including sedation, neonatal circumcision, and vascular and urological techniques
Each chapter follows a consistent structure: indications and contraindications first, then anatomy and equipment, ordered technique steps, and closing sections on complications, aftercare, and defensible documentation. Recurring decision points, technique steps, and safety alerts allow rapid navigation under time pressure.
Twelve quick-reference appendices consolidate anesthetic doses, suture selection and removal timing, corticosteroid injection volumes by joint, synovial fluid analysis, Fitzpatrick classification, wound closure decisions, post-colposcopy management, and other data for use in the moment.
Written by Jerry R. Lemieux, this first edition works both as a structured curriculum in ambulatory procedures and as a just-in-time reference. It compresses the reasoning, sequences the steps, and marks the hazards, so the clinician arrives at the bedside prepared rather than improvising.
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