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Issue 4 - August 2011 |
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From the Editors Desk
Welcome to another edition of The Responder. The fantastic weather we have been having in Cape Town seems to be on its way out. With the prospect of bad weather, driving conditions become seriously challenging. With the challenging driving conditions comes the eventual call-out to motor vehicle accidents. Motor vehicle accidents unfortunately involve high-energy trauma. Car manufacturing companies are investing a lot of money in vehicle safety; unfortunately vehicle safety has very little impact on the pedestrian who is struck at high speed. In high-energy traumatic events, unstable fractures of the pelvis are commonly seen. A multidisciplinary focused approach can largely impact on patient outcome. This month’s article focuses on pelvic fractures and more specifically, the role of the Pelvic Binder in the acute phase of care. Be Safe Paramedical is pleased to bring you some excellent specials on our range of quality laryngoscopes. We once again invite you to make use of the healthcare diary column by sending us information on your organisation and any training events planned for the months to come. Yours in Healthcare
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Be Safe Product News Be Safe Paramedical are pleased to announce that stock of our new improved jump bags have arrived. We have almost tripled the strength of the outer material from a 600Denier to a 1680D. We are now only using YKK zippers on our bags. Contact us to place your orders. |
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Be Safe Specials
Be Safe Paramedical Laryngoscope with LED Bulbs
Be Safe Paramedical Laryngoscope - Fibre Optic
Be Safe Paramedical Laryngoscope - Fibre Optic |
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Health Focus Pelvic Fractures and Emergency Care |
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High-energy trauma generally results in an unstable pelvic fracture and is associated with disruption of vascular structures and severe haemorrhaging. Patients with unstable pelvic fractures, who present with shock, may have a mortality rate as high as 50%. In addition, associated injuries to the head, chest and abdomen, which commonly accompany high-energy trauma, may increase mortality to nearly 100%. The most common source of bleeding in high-energy pelvic injury is from exposed fractures, soft tissue structures and local venous vasculature. Although not as common as venous bleeding, arterial injuries may also provide a life-threatening source of bleeding in unstable pelvic fractures. In the acute phase of care, focus should be on stabilisation of the fracture by means of a Pelvic Binder, assessment and management of associated injuries and rapid transfer to a surgical facility for definitive care. Manual manipulation of the Pelvis during physical assessment should be performed very carefully. Attempts to assess for pelvic instability can result in haemodynamic instability as clots are dislodged from local bleeding sites.
Haemodynamic instability is a good indication that there is an active bleed. Haemodynamic instability is defined as patients who are non-responders to intravenous fluid therapy. This can be assessed by administering small boluses of fluid (of between 250 – 500ml) and assessing against cardiovascular response. Patients should be considered to be actively bleeding if there is only temporary or no improvement in cardiovascular status following small boluses of fluid. Patients who are actively bleeding should be managed with a permissive hypotension approach until haemorrhage control is surgically achieved. Large volumes of crystalloid should be avoided as they cause dilution of blood and clotting factors. The placement of a Pelvic Binder serves several functions:
There are several variations of the pelvic binder available on the market. Choice is largely based on personal preference, however the above factors should be considered carefully when evaluating your needs. The concept of ‘one size fits all” has very little or no value in emergency patient care. You should be considering a product that meets all your patient size needs. Please see the Be Safe Product Showcase column for information on the PelviGrip.
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Be Safe Product Showcase Pelvigrip Pelvic Binder The PelviGrip marketed and sold by Be Safe Paramedical makes binding of suspected unstable pelvic fractures easy and efficient. Unlike other versions of the PelviGrip, the Be Safe Paramedical version has included an extra large size PelviGrip as part of the standard kit. PelviGrip properties:
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Healthcare Fun
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Healthcare Diary The third biennial Emergency Medicine in the Developing World Conference will be held at the Cape Town International Convention Centre from 15 to 17 November 2011. The theme for this conference will be Education and Training in Emergency Medicine in the Developing World. The conference will once again host a number of internationally renowned speakers from around the globe presenting an academic, in depth programme with relevant learning opportunities. In addition, there will be a number of pre-conference workshops on a host of Emergency Medicine related topics It’s an event not to be missed. For more information on costs and the registration process please visit: www.emssa2011.co.za
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We welcome your comments and feedback Contact the Editor
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Cape Town - Head Office Johannesburg Office |
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