Bill
Do you mean Midazolam alone? No analgesia? Sure, patient satisfaction may be
fine but Midazolam has a great amnesic effect, so that may mean they have
forgotten the torture you put them through!
Regards
Mike Dudley
Airedale
----- Original Message -----
From: Richard BAILEY <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 02, 2002 3:28 AM
Subject: Re: Bier's Block
> Is anyone else out there using sedation [midazolam] for this? Our Biers
> tournequet passed away a couple of years ago and I got fed up with waiting
> for our business manager to stump up the cash to replace it. I've never
been
> a big fan of the "haematoma block" having witnessed the orthopods
[ab]using
> the technique in their torture chambers. I therefore extended the sedation
> policy we were already using for dislocated shoulders etc with advice re
low
> incremental doses in the elderly, in resus, full monitoring etc. To date
> [touch wood] no problems, good results [orthos not moaning], and satisfied
> patients [SHO audit project earlier this year]
>
> Best wishes, Bill Bailey
>
> ----- Original Message -----
> From: Adrian Fogarty <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, September 30, 2002 6:40 PM
> Subject: Re: Bier's Block
>
>
> > A lot of issues coming up here!
> >
> > Firstly with respect to haematoma blocks, I'm not convinced these can be
> > done much faster than a Bier's; I do a Bier's in less than 20 minutes,
all
> > in, with a cuff time of 15 minutes. Secondly I find many fractures are
too
> > impacted to allow easy access for a haematoma block, or conversely so
> > markedly displaced that I don't believe a local injection can
effectively
> > anaesthetise them. Thirdly the only time I've seen toxicity (mild) was
> with
> > a haematoma block - well you are injecting local into a vascular marrow
> > cavity, aren't you!
> >
> > I still do the occasional haematoma block however, if the patient is
older
> > (less vascular bone) and if the fracture is suitable (can get my needle
> into
> > it easily, and which doesn't require much manipulation). I still don't
get
> > the analgesia that I get with Bier's however (i.e. complete block). But
> > perhaps my haematoma technique isn't as good as it could be, so I'd be
> > grateful if someone (perhaps John Black) could enlighten me on their
> > technique, including doses, injection site and timing etc.
> >
> > Adrian Fogarty
> >
>
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