shoulder dislocation

Shoulder DislocationShoulder DislocationDraft model to test audio, click on Draft model to test audio, click on

small speaker on slidesmall speaker on slide

ApproachApproach

Reassurance Reassurance

Position of ComfortPosition of Comfort

AnalgesiaAnalgesia

Rapid assessment and XrayRapid assessment and Xray

Prepare for RelocationPrepare for Relocation

HistoryHistory

MechanismMechanism Past InjuriesPast Injuries Symptoms suggesting Neurological injurySymptoms suggesting Neurological injury AllergiesAllergies Last mealLast meal Medical historyMedical history

ExamExam

The Whole Patient, vitals etcThe Whole Patient, vitals etc Position Held by PatientPosition Held by Patient NeurovascularNeurovascular Open Wounds/ DeformityOpen Wounds/ Deformity

InvestigationInvestigation

Xrays : APXrays : AP Lateral, Y viewLateral, Y view Scapular if indicatedScapular if indicated

RelocationRelocation

Best done in a sedated patient ,sedation by Best done in a sedated patient ,sedation by trained senior doctors only (see procedural trained senior doctors only (see procedural sedationsedation

Propofol 1 mg/ kg bolus and .3 mg/kg thereafter Propofol 1 mg/ kg bolus and .3 mg/kg thereafter if requiredif required

If no facilities to sedate then adequate If no facilities to sedate then adequate analgesia, Fentanyl 1 mcg/kg, and thereafter .3 analgesia, Fentanyl 1 mcg/kg, and thereafter .3 mcg/kg as required, plus nonsedating doses of mcg/kg as required, plus nonsedating doses of midazolam, 0.05 mg/kg .midazolam, 0.05 mg/kg .

More to come More to come

POSTERIOR, Banchardts and Hill sachs POSTERIOR, Banchardts and Hill sachs to goto go

Relocation MethodsRelocation Methods

Principles of least traumatic MethodPrinciples of least traumatic Method Traction without rotationTraction without rotation Patient and Muscle relaxation, attainable Patient and Muscle relaxation, attainable

in the non sedated patient.in the non sedated patient. Scapular rotationScapular rotation

MethodsMethods

NB Video with live model and real patient NB Video with live model and real patient showing various techniques , will showing various techniques , will emphasise analgesia without sedation emphasise analgesia without sedation techniques more appropriate to target techniques more appropriate to target audienceaudience

After CareAfter Care

Immobiliser SlingImmobiliser Sling

Orthopaedic referralOrthopaedic referral