Sedation is NOT analgesia!

Just a reminder to trainees and docs alike that reducing and manipulating is no soft feat.
A case like one shown below requires not just sedation but much analgesia.
Apart from being humane, the synergistic effect also reduces your sedative dose and hence a less riskier sedation.
For those interested: describe and interpret.


Description:    
- AP Xray of left ankle
- open, comminuted fracture - dislocation of ankle
- tri malleolar and also involving distal fibula (spiral#)
- mortice completely disrupted

Interpretation:
- needs immediate reduction and stabilisation
- procedural sedation if no OT available soon
- remember neurovascular obs
- remember other injuries
- remember ANALGESIA