Welcome to this week’s edition of Wednesday Wrap-up!
We had a great conference day including a great discussion on how to deal with anterior shoulder dislocations. Dr. Melton presented an EBM review of the literature comparing intra-articular lidocaine to procedural sedation for reducing shoulders. The evidence suggests that there is no significant difference between the two when it comes to the primary endpoint of successful reduction. However, the controversy is really over complications which the existing literature is quite weak in addressing as none seem to include adequate longterm follow up. I think the concluding remarks of the discussion were very important which is that we need to be familiar with multiple techniques for both the reduction and for providing analgesia and possibly sedation for this scenario. Dr. Cioe mentioned a great website for learning these various techniques created by two ED doc’s from Australia so check it out: shoulderdislocation.net
Would love to here everybody’s thoughts on their approach. What’s your agent of choice when it comes to analgesia and/or sedation and what’s your go-to technique for reduction? Leave your thoughts below.
Thanks for reading,
JK
The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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Jay Khadpe MD
Editor in Chief of "The Original Kings of County"
Assistant Professor of Emergency Medicine
Assistant Residency Director
SUNY Downstate / Kings County Hospital
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