A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction

The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

show abstract

“…There are also several descriptions of using ultrasound in the emergency setting to guide intra-articular blocks [214, 215]. …”

Section: Diagnostic Applications Of Ultrasoundmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

View full text Add to dashboard Cite

show abstract

“…1). At full text, 12 primary articles, [11][12][13][14][15][16][17][18][19][20][21][22] 49 systematic review (SR) articles and 12 guidelines [72][73][74][75][76][77][78][79][80][81][82][83] were included.…”

Section: Search Resultsmentioning

confidence: 99%

“…As evidenced in this review, there are multiple techniques available to the ED clinician to reduce an anteriorly dislocated shoulder joint, with varying rates of success reported in the literature. [11][12][13][14]20,21,37 As the techniques vary in terms of patient and clinician positioning, resources required, the need for procedural sedation, and body shapes and sizes, clinicians are encouraged to be comfortable performing several different techniques to allow for optimum success. 6 The importance of pre-and post-reduction X-rays were also highlighted in the review (Fig.…”

Section: Discussionmentioning

confidence: 99%

Review article: Best practice management of common shoulder injuries and conditions in the emergency department (part 4 of the musculoskeletal injuries rapid review series)

Strudwick

McPhee

Bell

et al. 2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

Shoulder injuries are a commonly presenting complaint to the ED. In the absence of an obvious deformity, they can be difficult to assess and definitively diagnose because of the multiple structures that cause shoulder pain, the acuity and severity of pain and the lack of range of motion in the ED setting. The quality of ED care provided to patients with musculoskeletal shoulder pain is crucial to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common shoulder injuries and conditions in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites. Primary studies, systematic reviews and guidelines published in English-language in the past 12 years that addressed the acute assessment, management, follow-up plan or prognosis were considered for inclusion. Data extraction of included articles was conducted, followed by quality appraisal to rate the level of evidence. The search revealed 1902 articles, of which 73 were included in the review (n = 12 primary articles, n = 49 systematic reviews and n = 12 guidelines). This rapid review provides clinicians who manage shoulder dislocations, fractures and soft tissue injuries in the ED a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is strong evidence to support taking a thorough history and physical examination, with cautious use of special tests because of their poor diagnostic accuracy. Key points regarding the diagnosis and management of these injuries are provided.

show abstract

“…Considered a best practice for central line placement, the use of ultrasound guidance confers the advantages of enhanced procedural success and patient safety and furthermore has transformed other procedures such as paracentesis, arthrocentesis, and nerve blocks . Landmark‐guided peripheral nerve blocks have long been utilized for laceration repairs, joint reductions, and pain control; however, one study noted that more than 30% of nerve blocks fail if performed by anatomic landmarks alone. The addition of ultrasound guidance has made regional anesthesia procedures faster, more accurate, and more successful as a pain management modality .…”

mentioning

confidence: 99%