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Fractures
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Do not do
Analgesia: Non-steroidal anti-inflammatory drugs (NSAIDs) are not recommended as pain relief for patients with hip fracture.
June 2011
Do not routinely assess fracture risk in people aged under 50 years unless they have major risk factors (for example, current or frequent recent use of oral or systemic glucocorticoids, untreated premature menopause or previous fragility fracture), because they are unlikely to be at high risk.
August 2012
Do not routinely measure bone mineral density (BMD) to assess fracture risk without prior assessment using FRAX (without a BMD value) or Qfracture. FRAX is the World Health Organisation fracture risk assessment tool, which can be used for people aged between 40 and 90 years, either with or without BMD values, as specified.
August 2012
Do not offer non-steroidal anti-inflammatory drugs (NSAIDs) to frail or older adults with fractures.
May 2016
Do not use gas and air (nitrous oxide and oxygen) on its own when reducing dorsally displaced distal radius fractures in the emergency department.
May 2016
Do not use a rigid cast for torus fractures of the distal radius.
May 2016
Do not irrigate open fractures of the long bones, hindfoot or midfoot in pre-hospital settings.
May 2016
Do not rely on capillary return or Doppler signal to exclude vascular injury.
May 2016
Do not routinely use whole-body CT to image children (under 16s). Use clinical judgement to limit CT to the body areas where assessment is needed.
May 2016
Do not log roll people with suspected pelvic fractures before pelvic imaging unless: an occult penetrating injury is suspected in a person with haemodynamic instability, log rolling is needed to clear the airway (for example, suction is ineffective in a person who is vomiting).
May 2016
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