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Update: BOAST Guidance If a patient with a #NoF (or other fragility fracture requiring admission) has received a head injury requiring CT a CT Neck… Read more

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

This guideline is a brief summary of the RCEM 2012 Safe sedation in the ED and RCEM – Pharmacological Agents for Procedural Sedation and Analgesia… 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

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… Read more

During the Covid-19 pandemic alternatives to LMWH have been agreed – [For those who can’t inject themselves] Read more

Bleeding on Dabigatran? <C>ABCD – as usual trying to stop bleedBloods: FBC, Clotting, U&E, G&SDiscuss with Haematologist (esp. if taken within 12-24hr)Idarucizumab (PRAXBIND) 5g IVFound… 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

Measuring for and advising patients on the use of elbow crutches is an important skill for ED staff. Read more

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

Haematoma blocks can be a safe and effect method of pain relief to facilitate reducing Colles’ fractures. What to give? 1% Lidocaine Onset 10-15min Offset… Read more

Background Defined as any traumatic injury to the head other than superficial facial injuries. The commonest cause of death and disability in people age 1-40… Read more

We are regularly doing femoral blocks next to major vessels. So warn the patient of the symptoms, & keep them monitored(at least 15 min). Symptoms… 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

Each year 1:15 of the adult population will seek medical help for Lower Back Pain, that is 2.6 million patients in the UK. Most Lower… 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

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

Bleeding under the nail from blunt trauma can be very painful. Lucky we have the tools on hand to ease some of that pain. Read more

In recent incidents we have had significant delays in giving OCTAPLEX, So ….. Activate EARLY in head injury patients on warfarin. Order on EPR &… Read more

Clavicle fracture is a common presentation and some patients can be managed at home without fracture clinic follow up. Inclusion Criteria Isolated mid-shaft clavicle fracture… 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

Primary Eyecare Acute Referral Scheme 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

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 patients case… 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

Changes in: Tetanus prone and High Risk definitions Recently there have been supply problems with Human Tetanus Immunoglob­ulin, currently we are using the alternatives below. Post-Exposure… 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

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

Upper limb (UL) and especially shoulder injuries are a fairly common presentation within the ED, but in the acute phase can be difficult to give a… Read more

Consider in ALL over 16’s with lower limb immobilisation. Bloods not required for everyone. Prescribe for 2 weeks (to cover any delay to # clinic)… Read more