C-spine injury ranges from the obvious fracture-dislocation to the less obvious ligamentous injury, affecting about 2.5% of blunt trauma patients. However, ALL of them are serious and can lead to life changing injuries, that we obviously don’t want to miss. Unfortunately reported miss rates range from 4-30%. [IJO 2007]
Category: MSK
Vaccination Schedules UK & International
Working out what your patient might have been vaccinated for can be tricky, and more so if they were raised outside of the UK. Luckily there are a couple of tools online you can use to make this easier.
Return to Police Custody
It is vital that patients returning to police custody as discharged as safely as possible. Part of that is ensuring the custody team has adequate information about the patient. So so complete the Return to custody form, documenting…. Read more
Hair Apposition Technique – HAT
Really useful method to close linear head wounds that you wouldn’t normally use glue for within the hair (esp. in children)
- Reduced pain
- Reduced follow up
- increased patient satisfaction (less pain and no need to see again)
- Faster and increased staff satisfaction
Snake Bites
In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
- Don’t Cut & Suck!
- Treat what you see
- Call Toxbase
PEARS
Rhabdomyolysis
We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how to diagnose and who needs admission to treat. So its important to consider both clinical context along with laboratory values
Rape & Sexual Assault
Don’t
Preform intimate examinations on Sexual assault/Rape patients
- Unless life-threatening injuries are suspected e.g Haemorrhage.
- As our examination will inevitably destroy evidence that may aid this patient’s case
Do’s
- Consider contamination injury (HIV, HepB, HepC) – Guide
- Consider emergency contraception
- Children must have police referral for safeguarding
- Refer to The Sexual Assault Referral Centre, either via Police or Self referral
Posterior Shoulder Dislocation
Posterior shoulder dislocation is far less common than anterior dislocation. But it is commonly missed with some sources stating 50% of posterior dislocations are missed in the ED. Read more
Tick-Bourne Diseases
The prevalence of diseases transmitted by tick bite have increased in recent years, within the UK. And it is now recognised that there are 3 main infections
- Lyme Disease
- Tick-Bourne Encephalitis
- Babesia
