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Studies suggest around 1% of hip fractures are missed on plain X-ray. So as usual you must combine clinical  and radiological findings. Read more

BOAST Guidance #NoF patients (or other fragility fracture) who requiring CT Head (for head injury) also be performed a CT Neck Fragility fractures indicate the patient is at high… Read more

A common sporting injury, especially in disciplines that require stop start sprints or rapid changes of direction   Read more

  One of the most common shoulder injuries, acromioclavicular joint (ACJ) dislocations account for around 9% of shoulder girdle injuries   Read more

Dog, and other mammalian bites, are a common presentation with the ED. They can be easy to treat, but need some particular attention if we… Read more

A new burns referral pathway has been developed with Mid Yorks to securely send images of the patients burn. Allowing the burns team to arrange… Read more

Although in ED we cannot prevent the primary injury, our objective is to recognise and prevent secondary injury. Through the use of the agreed standards… Read more

Radiology are now requesting blood pregnancy testing reproductive females from 10-35days from last period. But what is wrong with urine pregnancy testing? Read more

Great review of shoulder reduction, techniques and sedation.  Learning points: Most techniques will work 80% of the time (Best results tailor the technique to the… Read more

Domestic abuse can affect anyone and often its not readily disclosed on an ED admission. We must be alert to the fact some of our… Read more

What should you send to Eye Clinic and how soon? Read more

Slide show – HERE Read more

Haematoma blocks can be a safe and effect method of pain relief to facilitate reducing Colles’ fractures. It is also worth considering Penthrox as an… Read more

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… Read more

Dislocation of a Native Hip Uncommon – High-Energy injury All patients presenting with a suspected native hip dislocation following trauma (including falls from standing) must… Read more

Inclusion Criteria – All closed neurovascular intact adult humeral shaft fractures Exclusion Criteria – Intra-articular fractures of either the proximal or distal humerus, and surgical… Read more

There is was a national shortage of Intranasal Diamorphine therefore many departments are now more comfortable using Intranasal Fentanyl as a replacement for rapid provision… Read more

Used for a several types of knee injury, the knee splint provides support and comfort to the knee joint, whilst allowing for the patient to… Read more

This is a relatively common  presentation within the ED that has a myriad of possible diagnoses ranging from sprain to malignancy. One thing to remember… Read more

A Lisfranc injury describes an injury of the foot between the metatarsal and tarsal spaces. Around 20-40% of Lisfranc injuries are initially missed, so a… Read more

Lower limb (LL) and especially knee injuries are a very common presentation within the ED, but in the acute phase can be difficult to give a… Read more

YAS crews may on occasions (rarely) bring us a Major Trauma patient that meets the criteria for bypass to the MTC because they have a… Read more

The depth and type of sedation required in children depends on the procedure to be carried out. With the exception of procedures expected to cause… Read more

Morton’s Neuroma is a painful condition resulting from the fibrous thickening of the plantar interdigital nerve of the foot.   Often described as feeling like… Read more

Neck of fifth Metacarpal (Boxer’s) fractures are a common injury, and how we treat them locally is changing.   Read more

Activate EARLY in head injury patients on warfarin. Order on EPR & Paper [see below] Infuse over no more than 30 min Recheck INR at 30… Read more

RCEM 2022 Safe sedation in the ED and RCEM Ketamine for paediatric procedural sedation guideline. Please read these documents in full or participate in RCEM… Read more

  Infection in the skin fold (or paronychium) to lateral edge of the nail (of the finger or toe, but most commonly finger). Leads to a… Read more

Penthrox is an inhaled, patient controlled analgesic for use with moderate to severe acute pain associated with trauma.  Not to be used in atraumatic pain,… Read more

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… Read more

Recent Incident: Bat contact was not recognized (effectively touching a bat without gloves means treatment is recommended) Rabies is an acute viral encephalomyelitis caused by members of… Read more

Some Radial Buckle #’s in children can be managed with: Well fitting splint  Advice sheet This decision tree must be followed to identify suitable patients… Read more

Getting some of the rarer antidotes has recently been clarified across Yorkshire – LEEDS Guide Read more

What is retrobulbar haemorrhage? Rapidly progressing haemorrhage into the retrobulbar space which is rare but potentially sight threatening. Retrobulbar haemorrhage causes a rapid rise in… Read more

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… Read more

URM! anyone for Rock Paper Scissors OK (RPSOK) Assessment of nerve function after upper limb injury in children has been shown to be poorly documented.… Read more

First Aid (ALL) Encourage bleeding Wash with copious amounts of water or saline Don’t Suck Don’t use Caustic agents   Read more

The population is ageing and thus our ‘typical’ trauma patient is also changing. In 2017 the TARN report “Major injury in older people” highlighted the… Read more

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… Read more

GIRFT – Pathway   1. Red Flags: Has the patient developed any of the following? Difficulty initiating micturition or impaired sensation of urinary flow Altered… Read more

Invented by a Welshman ‘Hugh Owen Thomas’, the introduction of this simple device in World War 1 went on to reduce the mortality of #femurs… Read more

Used to immoblise a thumb due to fracture or ligamental injuries. Read more

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… Read more

TXA a bleeding wonder drug! Crash 2 Study (2010) Multi-Centre RCT of the use of TXA in trauma Inclusion – Adult trauma patients with ≥1… Read more

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… Read more

Select the appropriate body area for guidance table No Spinal injuries, back pain, Cauda Equina, foot drop etc to be referred to VFC How to… Read more

Walker Boots are an alternative to conventional casting materials, which immobilises the foot and ankle at 90 degrees, where the limb doesn’t need to completely… Read more

Single and Double layer wool and crepe bandaging Most commonly in the ED setting used to gently restrict movement of a joint, either due to… Read more