Abstract
Purpose
Dislocation of the shoulder is rare in the prehospital setting. The medical specialities of the emergency physicians are heterogeneous, and the level of experience is different. Aim of this study was to evaluate the feasibility, sufficiency, and need of prehospital reduction.
Methods
Over 12 months, 16 rescue stations in Germany and Austria documented cases. Points of examination were: incidence of reduction, influence of pathological findings, therapy and effectiveness of reduction.
Results
We included 70 patients. A reduction was undertaken in n = 47 (66.6 %). In n = 70 (100 %) perfusion was without pathological finding after reduction, all n = 7 (10 %) neurological pathologies declined after reduction. There was no significance in total implementation of prehospital reduction between surgeons and anaesthetists. N = 63 (90 %) of all patients received an immobilisation of the shoulder. N = 68 (97 %) of all patients were transported to a hospital. Time to arrival in hospital was in n = 50 (71.4 %) ≤10 min, in n = 17 (24.2 %) ≤20 min and in n = 3 (4.4 %) ≤30 min.
Conclusion
Implementation of reduction is independent of pathological neurological or vascular findings. Knowledge and skill is enough to perform a reduction quiet effectively in all emergency physicians. No specific technique can be recommended for prehospital use, the importance of being skilled is more important than one method. Early reduction was performed most rapidly in surgeons, but as well in the recommended time by other medical disciplines. On documented timings to admission hospital waiver of reduction is doubt. Therefore, a reduction in the prehospital setting is possible, but not obligatory.
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Conflict of interest
Tobias Helfen, Ben Ockert, Peter Pozder, Markus Regauer and Florian Haasters declare that they have no conflict of interest.
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Approval by the ethical committee has been obtained. (507-14 Ludwig-Maximilians University Munich).
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Appendix
Appendix
Emergency doctor’s vehicle, Bavarian Red Cross Neustadt, Germany.
Emergency doctor’s vehicle, German Red Cross Bad Bergzabern, Germany.
Emergency doctor’s vehicle, German Red Cross Merzig-Wadern, Germany.
Rescue helicopter ADAC Air Rescue Ochsenfurt, Germany.
Rescue helicopter, SHS Air Rescue Kaltenbach, Austria.
Emergency doctor’s vehicle, Professional fire brigade Hamburg, Germany.
Emergency doctor’s vehicles, Professional fire brigade Bonn, Germany.
Emergency doctor’s vehicles, Professional fire brigade München, Germany.
Emergency doctor’s vehicles, Professional fire brigade Münster, Germany.
Rescue helicopter, Federal Ministry of the Interior Hamburg and Eutin, Germany.
Rescue helicopters Heli-Ambulance Team Sölden and Zell am See, Austria.
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Helfen, T., Ockert, B., Pozder, P. et al. Management of prehospital shoulder dislocation: feasibility and need of reduction. Eur J Trauma Emerg Surg 42, 357–362 (2016). https://doi.org/10.1007/s00068-015-0545-5
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DOI: https://doi.org/10.1007/s00068-015-0545-5