Best shoulder reduction presentation of be seen and I’ve seen a lot. Gives me the confidence to start reducing shoulders in the ER. Thank you so much!!!
I had a dislocation in july should have gotten a video of it hahaha. this video is great, nothing feels better than a joint going back to where it is supposed to be :)
I just dislocated my shoulder TWICE in 5 days: the first in a fall, the second time it popped out when doing my physiotherapy “homework”. The first treatment I was fully sedated when the reduction was done. The second time was done with 10 locals in the shoulder and mild sedation - when the doc and his assistant moved the arm it slipped in like it was greased, and the pain disappeared like a light switch had been turned off!!!
I like the whole history lesson at the beginning. It helps me appreciate the techniques in their entirety. In my second week of ER rotation in PA school, I’ll be sure to use these techniques if I see an anterior shoulder dislocation. Thanks for the video!!!
Dr. Mohr, thank you for sharing this. You are an excellent instructor! The way that you demonstrated all the various techniques was impeccable. This was fascinating and speaks well to the fact that getting a patient relaxed can facilitate a much better outcome, for both the patient and the provider. Well done, sir!
Had this happen when I was a teenager while attempting to throw a boat engine on my shoulder. My shoulder and the engine just kept going back. A moment later my arm was 4-5” lower than normal. By buddy, who was training for the Olympics at the time grabbed me and put the shoulder back in joint in seconds after it happened. I never had any pain at the time or later to date. That was 40+ years ago! This is great information to know.
I have had 5 shoulder dislocations. The best method was a shot of muscle relaxer, waiting until you feel almost sleepy, and push your arm back in the socket. The muscle relaxer relaxes you and the muscles in the arm are not tense, thus making it easy to push it back.
I am a paramedic and I work in emergency of lady reading hospital Peshawar Pakistan since 2014.i work in emergency plaster room. We have shoulder dislocation patients I am using different method of traction. Some time it work butter but some time it not work but I appreciate the method and I will try to use the same method in future ...
Thank you so much for this! I'm not a doctor, but I do have hypermobility and (I realise this is bad!) I've been putting my shoulder back in myself for a while now when I have a subluxation. I've unwittingly been using the Milch technique, although I've not done the massage or traction/gentle rotation beforehand. I usually wake up to find my shoulder already out, panic a little and within a minute put it back in. Scans show that it's looking ok, and my physio says that I'm all good, but putting it back in is usually painful. Next time I'll wait and try not to cause any muscle spasms, and try to relax a little more beforehand/try your initial techniques!
Those docs do it sooo smoothly on the video. That happened to me today and let’s just say it went opposite of what’s in the video. I suffered a greatly today.
This video is dope, thanks. Relax the patient and it'll go in! it seriously wants to go back in and only requires smooth minor movement. Just dislocated my shoulder today but couldn't get over spasms or relax and seemingly fought it going back in.
All of those patients were very brave, my last disolcation wouldn't go back into joint possibly due to the 2 operations that should have prevented dislocation happening agiain
Thank you.. I had a stubborn one from a fall a few weeks ago and with HEDS I have gotten used to taking care of them myself but this one was from falling right on my arm
Is it important to ensure that it is an anterior dislocation as opposed to posterior or inferior by getting an x-ray before attempting these maneuvers?
Good question. If previous anterior dislocations and minimal trauma then often proceed without an x-ray confirmation if clinical exam is consistent with anterior dislocation. If significant trauma and/or first dislocation more often than not will get an x-ray to confirm it is an anterior dislocation. - Julian Marsden, Clinical Resources Lead, EM Network - www.bcemn.ca
They had to do a conscious sedation for me because my muscle spasms were so severe. I could not take the pain either so it made sense to sedate me consciously. I did not remember a thing.
This happened to me last week. 1gram iv paracetamol, 10mg morphine, penthrox and I was still in 10/10 agony. Propofol sedation needed to before xray and reduction.I can't imagine it being manipulated without anaesthesia.
Thanks for the video. How "fresh" are these dislocations? I've had good success reducing shoulder dislocation at ski clinics without sedation for analgesia when the time from injury to reduction is short, but have had a harder time if there is a long period between dislocation and reduction attempt. What has been your experience?
Just had this done a few days ago. Gave me ketamine propofol amd Valium but the scream i let out was so loud. It hurt so bad I mean worst ive fealt yet but i also broke the humeral head
Mine hurts extremely bad as well. Had an accident at a trampoline park a few years ago and ended up landing all my weight on my right shoulder dead vertically and broke it out with a loud crunch. Has fallen out about 5 other times since including today. Today however was the first time I was not able to get it back in myself or with help. Happened at work and I had to be taken to the er where the MD on hand in triage told the nurses to get a shot of morphine and began slowly manuvering it till it finally just popped right back in with a jolt of pain. I can honestly say, a dislocated shoulder is the worst pain I've ever experienced. I wouldn't wish it on my worst enemy and hope I can one day get mine fixed. Hope y'all the same luck, God bless.
@@dannyhensley8306I agree , my shoulder dislocated yesterday , the pain was unreal , I vomited due to the extreme pain , the me gave me ketamine drug and they managed to put it back in its socket but the pain , what a nightmare
I have suffered dislocations of my right shoulder shoulder for many years, I've had 3 manor operations to prevent it happening, putty plat bristow's procedure, and rotator cuff repair job, on one occasion doctors tried to Manipulate the shoulder back into position they failed I cried like a baby it was so painful, the doctors then sent me to another hospital they did the same and failed, I had to be sent the theatre for full anaesthetic, quite a few years later I broke my left humerus, and as doctor wanted to Manipulate my broken arm while I was awake, told him he wasn't touching me without anaesthetic, he wasn't happy , walked away in a strop, the nurse's told me to stick to my guns, they didn't need to, I know how painful getting the shoulder back into joint, I was not letting an idot doctor Manipulate a broken bone without pain relief
I know the feeling. I'm just 21 and a few years ago, I was at a trampoline park with some of my friends. My dumba$$ decided to try a backflip on regular trampolines when I had never done one and landed all my weight, 250+ lbs, on my right shoulder dead vertically and broke it out. I've since had multiple times it has fallen out, once today actually. This was this first time I've ever not been able to get it in myself or with help and had to be rushed to the er. It was very painful but the good md on hand in triage said he had had his jump out a few times himself and got it right back in after just a little manuvering. Idk if I should get surgery though. You say you've had multiple surgeries, would u recommend I get surgery or no? I wouldn't want to go that far if there is a possibility I could get it to heal. It has fallen out a total of about 6 or so times
I can't relax, I have an anxiety disorder. 3 ER doctors couldn't get my shoulder back in while I was on conscious sedation. I had to be completely knocked out and fixed by an orthopedic surgeon.
Actually 11years back in the shoulder ,the collarbone is disconnected to the acromion and collarbone is moved to upward......Now my question is ,is it possible to do the treatment the now??
@@chantamarypatir6607 Thanks for your question Chantamary. If I understand it correctly, you describe a complete (3rd degree) Acromio-clavicular separation. This of course isn't the same as a dislocated shoulder (gleno-humeral) joint and cannot be reduced. However, In a patient who has this old AC joint injury this doesn't change which technique you might use for reducing their shoulder if it becomes dislocated. In a patient who has a concomitant or very recent AC separation AND a dislocated shoulder, you may choose to use techniques which do not use any traction because traction will cause pain in someone with a separated shoulder. I have seen a patient with both a complete AC separation AND a posterior shoulder dislocation (mechanism was a hard fall on the shoulder) and using a bit of sedation and External Rotation their shoulder was easily reduced.
I had a dislocated shoulder years ago, I put it back in my self wrong. Who do I contact to have it relocated right. I lay on my back and can not lay my are down flat like the other side.
The BC EM Network does not provide medical advice or responses to medical questions from individuals. If you have a medical concern, we advise you seek professional guidance by contacting your Family Physician.
You can throw all these methods out the window. All you need is the “park method” which is not mentioned in your video. No sedation,no pain medication needed.
