This is a simple technique for reducing dislocated elbow joints. May take a bit of strength, but the physics make sense!
Posted in Joint reductionAuthor: andyprocedures
Hip reduction: Whistler technique
This is a straightforward technique for reducing posterior hip dislocations.
Key elements of the technique are:
- Flex the patient’s unaffected leg at the knee
- Flex the knee on the affected side, slide your arm underneath placing your hand on the knee on the unaffected side, and use this as the fulcrum
- Lift with your legs (avoid lifting with your back!)
- Gently internally/externally rotate the affected hip whilst lifting
- Ensure you have an assistant placing downward pressure on the pelvis/ASIS
Posted in Joint reduction
Procedural Competency: learning and keeping new skills
This is a great podcast from Todd Fraser at Essential Critical Care (and Osler Technology fame). Todd interviews Associate Professor Marcus Watson who is the executive director of the Clinical Skills Development Centre in Brisbane about procedural competency.
Marcus describes how in healthcare we’re still pushing the boundaries of what we can treat, and what new treatments are going to be in 5-10 years, and very little of our attention goes towards how well we perform various tasks.
He also discusses comparisons with other industries such as aviation, where there are vested interests that place a much higher priority on analysis and measurement of competency, and the reasons behind this. An important issue in healthcare is the diverse range of skills, systems and organisations we operate in, so trying to define all competencies (for example from a legislative viewpoint) is very difficult, and there is also no single regulatory authority in healthcare (as compared to aviation). But over-regulation also has drawbacks and limits.
The definitions of competency, proficiency and mastery, and how we measure and judge these are covered, as are the various factors that affect our learning of new procedures.
This is a fascinating interview for anyone interested in procedural skill learning and competency in healthcare, and is highly recommended listening.
Posted in Procedure TrainingCT-6 Femoral Traction Device 1
This is a video made by Queensland Ambulance Service on how to apply the CT-6 Femoral Traction Device. The CT-6 by Fare-Tec is becoming more widespread for pre-hospital use in Australia as it’s much more compact and lightweight than the old Donway splints, so you may see one popping up in your ED soon.
Posted in Plastering & Splinting
CT-6 Femoral Traction Device 2
The CT-6 by Fare-Tec is becoming more widespread for pre-hospital use in Australia as it’s much more compact and lightweight than the old Donway splints. This video demonstrates how to apply the CT-6.
Posted in Plastering & SplintingUpper Limb Plaster Splint Templates
Thanks to George Douros for allowing us to use his excellent plaster slab guides and templates for forearm injuries. These are designed to be used on the floor in ED, so feel free to print them out and try them today!
(Tip: To print the templates, click on the “Download” link below each document, then print)
1) Charnley Slab (Colle’s Fracture)
2) Thumb Spica (Scaphoid or suspected scaphoid fracture)
3) Volar Slab (Carpal, metacarpal and finger injuries)
Posted in Plastering & Splinting
Rapid Infuser Catheter – How to save a life with a 20 Gauge IV
This is a quick video I did over at the ETM Course blog. If you don’t now about RIC lines (rapid infuser catheters), watch this video, and read my other post about large bore vascular access devices!
Posted in Vascular AccessUltrasound guided radial artery line Insertion
This is a great video demonstrating ultrasound guided radial artery line insertion. I’d recommend watching until the end for the troubleshooting tips and tricks. I’ve been doing radial artery lines for over a decade and didn’t know some of these simple tricks for what to do when you’ve hit the artery but the cannula won’t feed, this will surely save you and your patients much frustration in the future!
Posted in Vascular Access