A few weeks ago I posted this scenario on FB .

60 yr male who was in an MVC and is pinned in the driver seat with an obvious closed femur fracture. Firefighters estimate extrication will take 20 minutes.

Patient is confused and screaming in pain and asks you to please give him something. He keeps trying to self extricate and is getting in the way of the firefighters tools.

Vitals BP- 86/52 HR- 118 SPO2 96% on RA RR 26

You are unable to obtain and IV and firefighters ask you if you are able to give the patient something IM to calm him down through the extrication process.

Do your guidelines discuss extrication sedation?

What drug and dose?

The comments were very interesting and I wanted to get someone well respected in the HEMS and prehospital environment on the show to give their thoughts. Dr. Cliff Reid is a seasoned retrieval physician who works for Sydney HEMS in Australia. This is his second time on FOAMfrat and we always have a great discussion. I think you will enjoy!