suspension trauma

• Previous message: suspension trauma
• Next message: Münchhausen Syndrome
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

Hi Paul,
You may have missed the recent discussion on tourniquets and several of us asked for anyones experiences with use in crush and HIP/susp trauma. Many groups that we train or work with use harnesses and for them this is a very real problem. Sadly the medical world have often not even heard of it and I have seen construction workers, fire-fighters and cavers trying to explain to paramedics and doctors the significance of this condition.

I was disappointed but not surpirsed by the lack of replies on this subject on the list.

On our last review of the literature in 2005, we were shocked that whilst the dangers are well recognised, there is a major lack of research on the subject. Probably because of the risks involved. 

What is also clear is that the UK Health and Safety guidelines fall well short of adequate in managing the most severe cases and the advice of 'not lying them down' is simply unrealistic if they are unconscious or shocked.

Despite the lack of controlled trials, our guys needed advice NOW, so we do have a protocol which involves tourniquets and staged release after harness removal, which is very similar to our 'crush relelase protocol'.
Whilst this may cause other problems, as suggested by Karim, there is no conclusive evidence of this and if the alternative is sudden death then the risk  may be unavoidable.

We are currently trying to develop a trial protocol to look at this, but our ethics committee is a tough not to crack in areas such as this and as the list has previously shown, comparisons to tourniquet use in elective surgery will just be dissmissed by many.

Happy to discuss off list

Cheers
Mark F
ATACC Medical Director
UK


----- Original Message ----
From: Grant Paul <paul.grant at oxamb.nhs.uk>
To: trauma-list at trauma.org
Sent: Sunday, 7 January, 2007 12:15:11 AM
Subject: suspension trauma


Has anyone had any experience of suspension trauma, also termed
orthostatic incompetence, specifically following prolonged suspension
whilst in a harness at height. I would also welcome any views or
experiences in the use of tourniquets in the management of this
condition.

Regards 

Paul Grant SRPara, Oxford.
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/traumalist.html

• Previous message: suspension trauma
• Next message: Münchhausen Syndrome
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]