Gautam wrote:
We too try to do all colles / shoulder's ourselves. We draw the line at
doing our own Bier's, partly because the anaesthetists have made it
plain that we are out on a limb if anything goes wrong and they won't
support us.

This is a very common response from anaesthetic departments. You should ask
yourself however, why do you need the anaesthetists' "support" for a
regional anaesthetic technique that is very much part of A&E expertise, and
which is very rarely practised by anaesthetists in any case. And what might
go wrong - toxicity from local anaesthesia? You should be able to manage
this, you don't need anyone's "permission" to manage such medical
emergencies, which might happen with any local anaesthetic technique,
particularly haematoma block. It's about time A&E folk recognised their
considerable expertise and stopped asking other people's permission to do x,
y and z!


Bill Bailey wrote:
If a patient presented during these hours we used to ask the Orthos for
help, its now not forthcoming and the patient has to return in the morning
for the manipulation - a retrograde step in my opinion.

No, it's understandable for the orthos not to take on your work just because
it's the middle of the night. What you need is resident A&E middle grade
cover at night, a damn sight more useful to the hospital than resident ortho
cover at night, isn't it? Of all the specialties which might have resident
middle grades, surely it should be obvious that A&E is the most necessary?

Adrian Fogarty