shoulder dislocation
DESCRIPTION
Trial of lectureTRANSCRIPT
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Shoulder DislocationShoulder DislocationDraft model to test audio, click on Draft model to test audio, click on
small speaker on slidesmall speaker on slide
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ApproachApproach
Reassurance Reassurance
Position of ComfortPosition of Comfort
AnalgesiaAnalgesia
Rapid assessment and XrayRapid assessment and Xray
Prepare for RelocationPrepare for Relocation
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HistoryHistory
MechanismMechanism Past InjuriesPast Injuries Symptoms suggesting Neurological injurySymptoms suggesting Neurological injury AllergiesAllergies Last mealLast meal Medical historyMedical history
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ExamExam
The Whole Patient, vitals etcThe Whole Patient, vitals etc Position Held by PatientPosition Held by Patient NeurovascularNeurovascular Open Wounds/ DeformityOpen Wounds/ Deformity
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InvestigationInvestigation
Xrays : APXrays : AP Lateral, Y viewLateral, Y view Scapular if indicatedScapular if indicated
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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 .
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More to come More to come
POSTERIOR, Banchardts and Hill sachs POSTERIOR, Banchardts and Hill sachs to goto go
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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
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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
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After CareAfter Care
Immobiliser SlingImmobiliser Sling
Orthopaedic referralOrthopaedic referral