Ankle dislocation + distal fibula fx

[NomadicMedic]

Well, because it's JUST an ice pack.

I'm all about increasing education standards and working towards professional education... But let's just call an ice pack an ice pack.

 

[Handsome Robb]

Well, because it's JUST an ice pack.

I'm all about increasing education standards and working towards professional education... But let's just call an ice pack an ice pack.

Our ePCR software calls them "cold pack applied" in the flow chart.

I guess cryotherapy would probably be a better term to describe the ice machine I have for my shoulder that circulates ice water through pads designed to fit on certain anatomical areas.

Best. Thing. Ever. Post surgery haha

 

[NomadicMedic]

Our ePCR software calls them "cold pack applied"

Wait... It doesn't say "cryotherapy"?

 

[Handsome Robb]

Wait... It doesn't say "cryotherapy"?

I don't wanna hear it! There used to be "cryotherapy used" or "cold pack applied" but they decided the first one was too complex for some people and there were too many items in the drop down to begin with.

I'm gonna call it cryotherapy from now on just cause it annoys you

 

[Handsome Robb]

Nice sig by the way haha.

 

[Tigger]

Our ePCR software calls them "cold pack applied" in the flow chart.

I guess cryotherapy would probably be a better term to describe the ice machine I have for my shoulder that circulates ice water through pads designed to fit on certain anatomical areas.

Best. Thing. Ever. Post surgery haha

Sadly cryotherapy can be used to refer to just applying ice packs. Once got into an argument with a former boss about whether or not pressure was required, apparently not.

The GameReady is the best thing to happen to rehab and sports medicine, I'm assuming that's what you have?

 

[Handsome Robb]

It's called the Cold Rush therapy system or something like that?

 

[Akulahawk]

I would have actually taped the pillow around the ankle, otherwise you hit a bump and it would hurt a heck of a lot. Agree that if decreased CSMs you need to pull inline and try to reduce.

In the ER i'd reduce it with propofol, after proper analgesia. More so they don't remember it than for muscle relaxation. For shoulder dislocations I inject the joint, try two or three methods for doing it without sedation, then they get propofol. Shoulders are one where preventing the patient from tensing up really helps the reduction.

By the time the patient gets to see you, the window of opportunity to reduce without sedation is gone. With those, you have to reduce pretty much right away before muscular splinting occurs or you have to cause sufficient sedation and muscular relaxation to allow the reduction to happen relatively easily.

 

[zmedic]

By the time the patient gets to see you, the window of opportunity to reduce without sedation is gone. With those, you have to reduce pretty much right away before muscular splinting occurs or you have to cause sufficient sedation and muscular relaxation to allow the reduction to happen relatively easily.

It's harder the longer it goes, but I've had some good results with some prone positioning and scapular manipulation, some hanging with weights. Often these are patients with multiple previous dislocations and are pretty loose. But if it doesn't go easily it's sedation time.

 

[Akulahawk]

It's harder the longer it goes, but I've had some good results with some prone positioning and scapular manipulation, some hanging with weights. Often these are patients with multiple previous dislocations and are pretty loose. But if it doesn't go easily it's sedation time.

And that's why the prone positioning, scapular manipulation with hanging weights works well in those patients. They're already loose and they know how things go. Of course with the first-time shoulder dislocations, you need to rule out fracture so...

But I'm glad you're willing to properly sedate patients to allow their musculature to relax enough to allow a relatively easy reduction.

Incidentally, I have a textbook that should work quite well as a hanging weight, and I would imagine most students would have such a book on hand, or more correctly, at hand to use!