"Bell, Simon" <[log in to unmask]>typed
> Attachment 1: ,text/html
> I would like to pose the following scenario :
> 99 yr old lady with a mechanical fall has bilateral colles #'s both
> requiring manipulation.
> We as a department referred for admission and manipulation in theatre (not
> necessarily GA) under the orthopaedic team,
The right thing to do IMHO.
> met great resistance at senior level
They would do/say that, wouldn't they???
> who felt a bilateral haematoma block should be done in A+E.
> In the end, the lady was admitted and had bilateral haematoma blocks in
> theatre....
> It has caused a little unrest and the issues is still not resolved. we feel
> bilateral haematomas blocks are unsafe
You are correct here. One haematoma block approaches the maximum safe
lignocaine dose sometimes.
Some of these very old people are very sensitive to Entonox, which you
possibly could give for quick manipulations, if you have a slick wrist
puller.
> and the lady needs to come in anyway as she wont be able to mobilise......
Definitely agree with you here. With both hand plastered, she'd be
unable to manage *any* self care.
> I would be interested in hearing peoples opinion on safety of the procedure
> and effects on theatre time etc...
--
Helen D. Vecht: [log in to unmask]
Edgware.
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