The Awake Shoulder Reduction- the way of the future
Feb 16, 2024
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Exploring the use of intraarticular analgesia over IV sedation for awake shoulder reduction. Discussing success rates, patient satisfaction, reduction techniques, and pain scores for anterior shoulder dislocations. Learn how to efficiently fix dislocations without the need for IV sedation.
Intra-articular analgesia is a viable alternative to IV sedation for awake shoulder reduction, reducing adverse events and length of stay.
Different techniques for reducing anterior shoulder dislocations can yield varying success rates and pain scores, suggesting the importance of tailored approach.
Deep dives
Comparison of IV Sedation and Intra-Articular Anesthetics for Anterior Shoulder Dislocations
The podcast delves into comparing the effectiveness of IV sedation and intra-articular lidocaine for reducing anterior shoulder dislocations. A recent meta-analysis revealed that while there was no significant difference in reduction success between the two methods, adverse events were significantly lower with intra-articular lidocaine. Patients receiving intra-articular anesthetics also experienced a shorter length of stay, showcasing the potential benefits of this approach in terms of patient outcomes.
Considerations for Shoulder Dislocation Reduction Techniques
The episode explores various techniques for reducing anterior shoulder dislocations, categorizing them into rotation and leverage, muscle balance and relaxation, and traction methods. A meta-analysis highlighted that Davos and Fairs techniques showed favorable success rates, while FAERS demonstrated superior pain scores during reduction. Although this study had limitations and an intricate statistical analysis, it provided insights into the potential efficacy of different reduction techniques.
Optimal Approach and Personal Practice for Anterior Shoulder Dislocations
In discussing the best approach for anterior shoulder dislocations, the podcast advocates for the use of intra-articular injections based on literature supporting their effectiveness and reduced length of stay. The host describes a personal practice of diagnosing dislocations clinically, using bupivacaine for intra-articular injections, and adopting a calm and informative manner with patients during reduction. The Cunningham technique, employing a tech for assistance, has proven successful in reducing dislocations, showcasing a method that balances efficacy and patient outcomes.
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Comparing IV Sedation with Intra-articular Anesthetics for Reducing Anterior Shoulder Dislocations
Anterior shoulder dislocations are common in the Emergency Department and let's face it, fun to fix. But this can be a time and resource intensive endeavor- especially if doing IV sedation. In this podcast we look at intraarticular analgesia as an alternative to IV sedation to allow for an awake shoulder reduction.