immediate management

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If if shock/risk of shock (eg suspected fractured femur) set up a Haemaccel i.v. drip (does not affect cross-matching)

Immobilisation: - possible spinal injury: don't move patient until expert help arrives then 'in-line immobilisation': collar, sandbags, tape and long spinal board - shoulder: high sling - arm, forearm, wrist or hand: sling - hip: place pillow laterally to prevent external rotation - hip,thigh or leg: pad and strap to other leg - always ensure that the immobilisation doesn't increase the pain - removing inappropriate splints is often a great relief on arrival at A/E departments

If immobilisation does not give adequate pain relief, use parenteral opiate & antiemetic unless contraindicated

Last reviewed 01/2018