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You are repairing a large laceration extending from the occipital scalp over the top of the head and onto the forehead of a 5 year old 20 kg child. You have the parent and nurse place the child his head in a sink under tap water to irrigate the wound. You anesthetize the wound with a total of 14 mL of 1% lidocaine. You put on a surgical mask and nonsterile gloves. You use staples on the scalp, transitioning to 5-0 polyglactin irradiated suture for the forehead. 

Which of these steps was not acceptable practice?
10 votes