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What we're gonna have a look at now is different ways and different techniques of elevating or moving limbs which work very effectively for bleeds, but also for evaluating or eradicating shock or limiting the effects of shock. So, the most common thing that everybody talks about is elevating the legs, "How are we gonna do it? How can we do it?" Well, we can use whatever we've got nearby. If you're in an office environment, we could just use an office chair and we can raise both legs up onto the office chair. Gravity then takes blood volume back to the core and will raise the blood pressure. Remember, when we're looking for blood pressure, the radial pulse is an important assessment. If the patient has a radial pulse, they will have a blood pressure above 90. Blood pressure above 90 means the internal organs carry on working and functioning effectively, but if the patient faints and we raise the legs or before we raise the legs, they may well not have a blood pressure or not have a radial pulse. But as soon as we raise the legs and the blood starts to pull back to the core of the body, the radial pulse comes back and the patient starts to show signs of coming around again.

If we haven't got a chair, if we're out in the street or in the community, we can replace the chair with our own knee. And if you use this technique, it means I'll still have my hands free, I've created a tunnel allowing us to have postural drainage, but I can still take radial pulses, I can still check the chest, and I can still evaluate everything else whilst using the elevation technique. We can also, if it's one limb, we can put one limb up onto a shoulder and again, we've still got two hands-frees to actually work on the patient. Remember, the way the limb bends allows us to elevate it, if we use the correct technique. So if I hold the ankle, the leg will lock itself in a vertical position. The arm will work exactly the same, but the arm bends. But if we've got a motorcyclist with a heavy bleed or we need to elevate a limb on a motorcyclist, if we put the helmet underneath the arm, the arm will stay elevated, as long as we balance it in that position, it will stay elevated.

If we put it in the wrong position, the arm will just fall but by supporting it and using the joint, we can actually use the arm, as well as the legs to give us elevation, reducing blood flow, reducing blood loss, and improving blood pressures. Different techniques for bringing the blood pressure up, to reduce the flow of blood loss from injuries and from wounds, postural drainage drains blood back to the core, gravity takes the blood to the core, blood pressure improves and the patient starts to improve. Different techniques to use posture, to use equipment, or ourselves to aid that recovery.