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Secondary survey; rocking the pelvis...What on earth is that about?
davidsf2 Offline
#1 Posted : 16 February 2012 17:42:11(UTC)
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When undertaking a secondary survey some of the FAW course people are rocking or applying lateral pressure to the pelvis. Per heading what the heck is that all about?
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daveolley Offline
#2 Posted : 16 February 2012 18:48:32(UTC)
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And they also suggest that first aiders should press on the neck and spine and palpate the abdomen!!!



To quote your phrase "what on earth is that about?
Darkwerks Offline
#3 Posted : 16 February 2012 18:51:56(UTC)
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We used to do this for pelvic fractures. very old technique, something I've not seen for years. Largely been discontinued - Even the ambulance service doesn't do it anymore.
I was taught to do this on a wilderness first responder course in 2000.
It's not something I'd expect to see on a FAW course and I'm surprised it's still being taught.
resq Offline
#4 Posted : 16 February 2012 20:54:59(UTC)
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Don't do it.
JonAcc Offline
#5 Posted : 17 February 2012 02:48:51(UTC)
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See some of the previous threads on secondary survey. This is an unsafe practice that was, as said previously, discontinued quite some years ago. Regrettably there are still people out there teaching this because they haven't done any CPD for years and are still failing people in their assessment if they don't do a reef knot
bryn9 Offline
#6 Posted : 18 February 2012 10:52:49(UTC)
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First aiders are not going to find a lot on SS, if its not obvious they wont see it. One of my neighbors fell down stairs and broke his pelvis, the ambulance lads checked him over they could not find it and let him walk to the van! O yes it did hurt. If they have wet themselves think broken pelvis if its smokey red it what I was told by the paraladsnlasses
ppp Offline
#7 Posted : 19 February 2012 21:03:07(UTC)
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broken pelvis is quite often accompanied by pain in the groin and could indicate fracture of pubic rami, mechanism of injury and age related bone problems should also be taken into account. If in doubt treat for worse, do not rock or 'spring' the pelvis.
Deek Offline
#8 Posted : 21 February 2012 20:23:47(UTC)
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The technique used to be used to detect un-natural movement and crepitus to ascertain a #pelvis but the practice is no longer used as it can cause more trauma or can cause secondary trauma in the case of an actual #pelvis.



If a #pelvis is suspected, which is mainly due to mechanism of injury, presence of incontinent of urine, severe pain, etc. they the patient should be kept still and not moved.



Best practice in the ambulance service is to apply a pelvic sling and 'scoop' the patient onto an appropriate stretcher. 
alec.cromack Offline
#9 Posted : 24 February 2012 07:04:18(UTC)
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So as a trainer should I just be instructing my students to feel down the side of the hips on a unconscious casualty instead of gently rocking than? I guess if a casualty was unconscious and on there back you would still have to look for injuries to decide which way you turn them.
JonAcc Offline
#10 Posted : 25 February 2012 02:06:09(UTC)
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A bit tired at the moment. Not long finished from over 16 hours. Has been busy! So if I miss something, apologies,   but .......



You will not detect a pelvic fracture in the pubic area just by feeling down the outside. Suggest your candidates check & eliminate bleeding, look for the overt signs of hip or pelvic injury. If you know the MoI, then if MoI indicates hip/pelvic injury, then they have one until proven otherwise i.e. by X-ray, not by feel. How many Joe Average first aiders are likely to have sufficient experience to feel around someone's hips and determine that something feels unusual?



I know there will be exceptions, but for the average first aider, keep it simple and do not point them in a direction that could cause serious harm to their patient
davidsf2 Offline
#12 Posted : 27 February 2012 13:44:47(UTC)
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Thanks all.
It's not something I would do and I certainly didn't when my 90 y.o. neighbour fell in the garden, pelvic fracture was almost a given. Ambulance arrived within 5 minutes

I just wondered where the practice came from, as I haven't read it in the first aid literature (going back to 1960s tripartite manual for voluntary ambulance services readership) it's not in ATLS manual, orthopaedic texts or clinical examination texts.
coco Offline
#13 Posted : 27 February 2012 15:44:30(UTC)
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Originally Posted by: davidsf2 Go to Quoted Post
Thanks all.

It's not something I would do and I certainly didn't when my 90 y.o. neighbour fell in the garden, pelvic fracture was almost a given. Ambulance arrived within 5 minutes



I just wondered where the practice came from, as I haven't read it in the first aid literature (going back to 1960s tripartite manual for voluntary ambulance services readership) it's not in ATLS manual, orthopaedic texts or clinical examination texts.
coco Offline
#14 Posted : 27 February 2012 15:45:57(UTC)
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P45 sixth edition of the VAS manual 1992. Quote - Feel both sides of the pelvic bone and gently “rock” the pelvis to discover any sign of fracture



coco

davidsf2 Offline
#15 Posted : 27 February 2012 17:38:56(UTC)
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Ah, thanks very much, I'm missing a couple of decades.
Useful to know whence that came to be able to point out it's a discontinued practice in current editions.

The 1965 (2nd ed) tripartite VAS manual is quite interesting from a historical perspective c.f the back to basics contemporary FAW literature; Silvester method, nerve gas tx, nuclear attack tx and the cold war / civil defence stuff.

daveolley
And they also suggest that first aiders should press on the neck and spine and palpate the abdomen!!!

et al [can't see how to multiquote]


The instructor isn't teaching the delegates to or rock or spring the pelvis, palpate the pelvis, abdomen c-spine (before roll to recovery pos'n) etc, they dont have a healthcare background to be able to instruct that; that's something one or two delegates have taken in presumably from previous FA or FAW courses.
alec.cromack Offline
#11 Posted : 28 February 2012 19:22:43(UTC)
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Originally Posted by: JonAcc Go to Quoted Post
A bit tired at the moment. Not long finished from over 16 hours. Has been busy! So if I miss something, apologies,   but .......



You will not detect a pelvic fracture in the pubic area just by feeling down the outside. Suggest your candidates check & eliminate bleeding, look for the overt signs of hip or pelvic injury. If you know the MoI, then if MoI indicates hip/pelvic injury, then they have one until proven otherwise i.e. by X-ray, not by feel. How many Joe Average first aiders are likely to have sufficient experience to feel around someone's hips and determine that something feels unusual?



I know there will be exceptions, but for the average first aider, keep it simple and do not point them in a direction that could cause serious harm to their patient




Thanks Jon for your info. What does MoI mean please?



Alec
JonAcc Offline
#16 Posted : 28 February 2012 20:34:28(UTC)
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MoI = Mechanism of Injury
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