During one year of rotations in the actual ER as a Paramedic I got to learn how to suture pretty well (way out of my scope of practice) but young docs always find pleasure in showing off and teaching others. I would not atempt to stich a face or a child since my threads are not the pretiest and I rather have somebody who does it every day and not once a week do it. But with rest anything goes. I would drop off my patient from a cardiac call than walk thru the er and doc would yell "hey Matt finish up for me" and there I go stiching somebodys arm. I know how to do it, I know the proper way of cleaning the wound but I would never stich anyone in the field . I would use direct pressure, elevation and pressure point and tk if had to, I even throw in up to 3000 cc of fluid in there to maintain you. Infection risk is to great as oposed to benefit. Plus sutures give false sense of secuirty. Yeah you stiched my leg it's not bleeding anymore I can go further.

Now to ligate a bleeder... I saw it being done but never did it my self. So this is plain simple no unless it is a case book scenario procedure I watched being done. Anything complicated (and it always is) would have to be controlled using bls stuff.

And some wounds are really tempting to stich too. They look easy and are not deep enough to be hard to clean. Still it's a no go. I will cover it, clean it, make buterflies out of tape but will not stich it.