J Emerg Med
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Review
Shoulder Dislocations in the Emergency Department: A Comprehensive Review of Reduction Techniques.
Shoulder dislocations are a common presentation to the emergency department and one of the most frequent types of joint dislocations. Studies have found that delays from presentation to first reduction attempt and failed attempt at initial reduction are associated with lower rates of overall reduction success. ⋯ It is essential for emergency physicians to be familiar with multiple different reduction techniques in case the initial reduction attempt is unsuccessful or patient-specific characteristics limit the ability to perform certain techniques. This article reviews several reduction maneuvers for shoulder dislocations, variations on these techniques, and advantages and disadvantages for each approach. It is intended to serve as a resource for those interested in expanding their knowledge of shoulder reduction techniques.
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The local anesthetic dosages used in the current literature in regional applications of local anesthetics are frequently high for surgical purposes, and there are no sufficient dosage studies for emergency department (ED) management. ⋯ The administration of 5 mL 2% prilocaine for pain control in FNFs in elderly patients in the ED can reduce systemic analgesic requirements by establishing effective analgesia in both intracapsular and extracapsular fractures.
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Outpatient referrals constitute a critical component of emergency medical care. However, barriers to care after emergency department (ED) visits have not been investigated thoroughly. ⋯ This study provides an overview of the impact of sociodemographic and departmental factors on attendance at outpatient follow-up referrals. Significant disparities exist with respect to referral attendance after emergency medical care. Informed resource allocation may be utilized to improve care for these at-risk patient populations.