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>----- Original Message ----- >From: "Paul Ransom" >Subject: Re: Flumazenil, Sedation and Fits >> For those of us out of the country last year, or having an off day during >> that posting, what exactly is the 'Belsham technique'? I remain to be >> convinced about the analgesia free reduction. > That, my dear fellow, is because you have not tried it! ;-) Here's how I do it... Sit the patient bolt upright and relax them with a bit of chat. Tell him that he should imagine his elbow is descending slowly to the floor and continue with the blarney. Whilst finding out what the patient's cat is called, apply traction at the elbow slowly and imperceptibly. You are now on the subject of what his ideal car is.. Apply external rotation very slowly. Gentle rotatory moves at various points may be helpful in overcoming spasm and relaxing the muscles. You are now talking about how rewarding your job is (list malcontents to omit this step!) Discussion of holidays that one has recently enjoyed is accompanied by either a gratifying clunk or the end stage described by Adrian Fogarty. Top tips: Never ever discuss Women, Politics or Religeon during the procedure or you will surely not succeed! If at any point there is any pain, stop and do not move. The pain passes. Continue thereafter. Genial disposition and chat is the key. Do not attempt if stressed or in a bad mood. Give it a go, good luck! -- Stephen Hughes SpR Anything & Everything, NE Thames