Anterior Shoulder Dislocation

Last night, a patient presented with bilateral anterior shoulder dislocations.

Here is what our Sr. ED resident had to say during morning report about the Scapular Manipulation Technique that he used -
1.  Inject lidocaine into shoulder joint (into hollow under the lateral surface of the acromion process)
2.  With the patient supine, as assistant provides traction inferiorly and upward, in order to elevate the shoulder off the bed.
3. After a couple of minutes of steady traction, you reach under the patients scapula.  One hand stabilizes the superior border while the other hand applies medial and upward pressure to the tip of the scapula.
4. The shoulder reduces.

from Joey Veloso, MD with input from Simon's Emergency Medicine Procedures