 |
 |
Indeed, I've never understood why an ex-fix is supposed to "magically" stop the bleeding any better than a tight belt or harness, or similar contraption. It's about time our specialty took a sensible approach to this subject. AF ----- Original Message ----- From: "Rowley Cottingham" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, October 12, 2005 10:23 PM Subject: Re: Surgeons and trauma teams Our orthopods (in particularly Martin Rolfe at George's) ask that ex-fixes are NOT applied as they make definitive treatment much more difficult. My particular favourite external device is the Stuart belt, invented by my friend Stuart Westbrook. It can be cinched tightly, and has pads that can slide round to provide pressure in the right place. Best wishes Rowley. -----Original Message----- From: Accident and Emergency Academic List [mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC) A & E - SwarkHosp-TR Sent: 12 October 2005 08:15 To: [log in to unmask] Subject: Re: Surgeons and trauma teams Don't confuse non resident with not quickly available. I'm non resident but usually make it in before the resident bods from other teams. If you call in the orthopod as soon as it becomes apparent that this is a sick trauma case, they ought to be in by the time you've got the ex fix kit out, adequate anaesthesia and airway sorted. With specific reference to pelvic fracture and ex fix, 1. If you feel ex fix application is something that needs doing within 30 minutes or so, maybe you should look at it being an A and E procedure rather than an orthopaedic one, so it can get done by someone who is actually in the department once the patient arrives. 2. However, it doesn't. Wrapping the pelvis in bandages or one of the proprietary devices is said to work about as often as ex fix does. With regard to general surgeons, anything that can't wait until the registrar makes it in from home is a consultant level case anyway (unless someone can give me an example otherwise). With AAAs in particular, I've not come across one done by an unsupervised trainee since they got rid of SRs. Matt Dunn Warwick This email has been scanned for viruses by NAI AVD however we are unable to accept responsibility for any damage caused by the contents. The opinions expressed in this email represent the views of the sender, not South Warwickshire General Hospitals NHS Trust unless explicitly stated. If you have received this email in error please notify the sender. The information contained in this email may be subject to public disclosure under the NHS Code of Openness or the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed.