Need for admission would depend on home circumstances, but does sound
likely. Although I'm happy manipulating patients in A and E even if they're
going to be admitted. Bilateral simultaneous haematoma blocks at the wrist
are likely to involve a dose of local anaesthetic that is either
subtherapeutic or toxic. Numerous papers around showing that surgeons don't
know the toxic doses of local anaesthetic agents. Sounds like a good
candidate for reduction by analgesia and gentle traction with fingers in
Chinese finger traps if you don't want to do a GA. I suppose no reason you
can't try/ supplement with low dose haematoma blocks.
Matt Dunn
Warwick
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