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Tehcnically, it would be a PE, just a 'sub-clinical' one.

At 20 minutes or when you get bored.

$40? It's off patent. You can buy one dose of it in the UK, at full list price, for the equivalent of $5.20.

EM & PHEM consultants mostly.

I think it's telling that they want to compare two forms of immobilisation and then don't actually measure immobilisation.

CRASH II was 4 years ago and pretty convincing. We've had tranny acid on ambos and in routine use for two or three years now.

Requires what now? Having x-rays is nice, but it's not necessary and in the case of a time-critical ischemic limb it's absence shouldn't delay reduction. I've never seen a fracture or fracture/dislocation (posterior shoulder dislocations are, however, an obvious exception) that requires...

I suspect that you're unlikely to find a single high-quality piece of research supporting this. As we all know, doing any form of prospective research on OOHCA is fraught with difficulty. I've found a few bits that, I think, added together, form a reasonable evidence base...

I thought PERT (Pre-hospital & Emergency Resuscitative Thoracotomy) was pretty high speed.

It's just trumpton trying to find something to do inbetween volleyball matches.

I wouldn't usually give GTN outside of sympathetic acute heart failure. I think the OP is right, this sounds like a relatively clear cut volume issue. But I suspect it's more likely to be renal rather than cardiac. Either way, a bit of fruse is the way forward in the first instance.

If it looked like that picture I'd by thinking about reducing it before transport because the skin over that mal looks pretty threatened. But, of course, that depends on your transport time. Other than that, not much else you can do, resting on a pillow seems reasonable.

How not to get attacked? Don't be a knob. The people who get the most drama at work are the ones who have aggressive body language, can't deescalate and won't walk away.

I've use Cook, EZ and BIG. I think that BIG is easily the best of the three requiring very little training, being dead simple and being quick.

Of course I do, I just don't care. It makes no difference to the treatment whether someone has wounds from a police baton or a Yardie's baseball bat.

Really true! In medicine at least; doctors regarded to have better communication skills and better 'bedside manner' received fewer complaints regardless of their clinical skills...

Why unfortunately? And anyway, what do you mean by criminal? A convicted felon? Misdemeanant? Suspect? Evildoer? Any patient escorted by someone with a gun and a badge? This thread stinks of bull:censored::censored::censored::censored:, supposition and prejudice.

:rofl: Anyway, in as much as there's a serious question in there; you just crack on. I see up to thirty patients in a 10 hour shift. I have not go the time and effort to give more than a flying :censored::censored::censored::censored: about what any of them may or may not be like.

I've only seen a couple of these; one rugby, one motorcyclist. Both were very hard to diagnose, there were no clues from examination, plain CXR revealed nothing, lateral sternum gave the diagnosis in the first and a very close look at a CT traumagram gave the latter. As with a broken rib...

DBO says these people go to a doctor but not by ambulance, does he mean they walk to the ED or do they find a PCP (I hear they're really abundant in the US)?