In article <[log in to unmask]
s.nhs.uk>, Belsham, Philip <[log in to unmask]> writes
>
>The point I want to make is that the reduction should cause no additional
>pain if you use the correct technique.
I have changed my practice since becoming involved with WEMSI. Out in
the woods analgesia is hard to find, and aggressively attacking an
injured shoulder with no XR is probably ill advised.
The WEMSI teaching is to use some 2 inch webbing in a figure of eight
around the humerus and elbow, tie it off behind the operators waist.
Sort out some counter traction so that the victim doesn't get dragged
across the floor. Kneel down next to them and lean gently back whilst
talking to them about whatever and possibly doing a little hypnosis.
The arm can slowly be brought up to the 'throwing a baseball' position
(if necessary). This takes some time of course. I have used a modified
version on 3 occasions and succeeded each time - once with no analgesia
in lad who was about to miss his coach home - and one of the patients
categorically told me that I would not get it back because he had had to
have a GA on the previous occasions that this had happened.
Analgesia seemed effective once this gentle traction was achieved
(maintenance of it is of course vital!)
Having said that - I don't do many
No more do I swing on shoulders with the victim sent off to happy land
whilst I sweat - but no doubt next week I will fail
FWIW
Cheers :)
--
Jel Coward
http://www.wildmedic.org
http://www.wemsi.org
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'There's no such thing as bad weather - just bad clothing"
Anon Norwegian
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