----- Original Message -----
From: "Doc Holiday"
> Yes, but how long will it take if you were to test the equipment first
The cuff is tested when I blow it up on the patient's arm! (What other way
is there?)
> and ALSO you have 2 patients who need to be done at the same time...
If half a dozen patients turn up at once, I can see the benefit of having an
anaesthetist. But I don't believe I've ever seen this happen (and I've
manipulated well over a thousand now). In my experience, patients with
colles fracture appear sporadically, so finding an anaesthetist for each
case would slow me down, not speed me up! Unless of course you organise your
SHOs to "save them up" for your appearance each morning - nightmare!
> Dose: I draw up 10ml 1% and use 7-8ml in the radial haematoma. If the
> ulnar styloid is tender by the time I finish injecting (slowly over
30-60s)
> then I shoot 1-2mls into its fracture site as well. Inject the radius by
> aiming at about a 45 degree angle for the fracture site from the dorsal
> aspect going distally. If much overlap, may need a more acute angle to get
> between the cortices. Use a green needle at least to power through if
> needed. Make sure you don't come out the other side - it helps to draw
back
> to spot the haematoma, but should not be necessary, 'cause you'll "just
> know". Keep your position while thr POP hardens.
I have noticed, with haematoma blocks, that the anaesthetic wears off if I
delay for 10 minutes; well it's the same principle as an intraosseous
injection, isn't it? So does anyone use adrenaline for these blocks? And if
not, why not?
Adrian Fogarty
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