• The (drug-free) Cunningham method
• Kochers method
• Scapular Manipulation
• Modified Milch
• Zero Position

As well as some tips on troubleshooting tricky shoulder dislocations.

We’ve already posted the first video, and we recommend you start with this (Neil’s excellent talk on all things shoulder dislocation) and will re-post the Cunningham Method video with some tips soon as well.

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The post Neil Cunningham’s shoulder reduction video gallery appeared first on ED Procedures.

This is a great, drug free way to reduce a shoulder, invented by Neil Cunningham. As Neil mentions in his definitive talk about shoulder dislocation and reduction, there may be times when you elect not to use this technique, but in patients with minimal pain/spasm, who can get their arm into the adducted position, it’s worth a shot if it avoids a potentially unnecessary procedural sedation.

Key points:

• Have the patient sitting as upright as possible
• Get the arm as adducted as possible – patient’s elbow as close to their side as they can
• Continually remind the patient to sit up straight, take slow deep breaths and relax their shoulders
• Shorten the biceps by flexing the patient’s elbow and rest their hand on your forearm/shoulder – this will prevent it pulling the humeral head medially
• Massage the trapezius, deltoid and biceps
• You won’t feel the classic “clunk” you get with traction techniques – but you will see the “step” disappear.

Reference:

A new drug free technique for reducing anterior shoulder dislocations. Cunningham, N. Emerg Med (Fremantle). 2003 Oct-Dec;15(5-6):521-4

The post Shoulder reduction: Cunningham Method 1 appeared first on ED Procedures.

Neil Cunningham who ran (the now defunct) shoulderdislocation.net site gives an amazing overview of shoulder dislocation and reduction. This is the definitive presentation on shoulder reduction, outlining the biomechanics of dislocation/reduction, patient factors that may make one technique more useful than another, risks and complications of various techniques, and some awesome pearls and demonstrations, including many tips on drug-free shoulder reduction.

We’ll post more of Neil’s videos soon.

The post Shoulder reduction – The definitive talk by Neil Cunningham appeared first on ED Procedures.

This is a simple technique for reducing dislocated elbow joints. May take a bit of strength, but the physics make sense!

The post Elbow reduction: interlocking hands technique appeared first on ED Procedures.

This is a straightforward technique for reducing posterior hip dislocations.

Key elements of the technique are:

• Flex the patient’s unaffected leg at the knee
• Flex the knee on the affected side, slide your arm underneath placing your hand on the knee on the unaffected side, and use this as the fulcrum
• Lift with your legs (avoid lifting with your back!)
• Gently internally/externally rotate the affected hip whilst lifting
• Ensure you have an assistant placing downward pressure on the pelvis/ASIS

The post Hip reduction: Whistler technique appeared first on ED Procedures.