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Shoulder Dislocation CPI
Clinical scenario
Dislocated shoulders are a common problem faced by emergency physicians. For patients they are often extremely painful injuries that they consequently require prompt attention if they are to be managed well. The vast majority >95%) of dislocations are anterior dislocations.
Audit question
Are shoulder dislocations managed appropriately according to best practice guidelines?
Method
Retrospective audit
Sample: 30-50 Emergency Department patient records
Criteria
Inclusions: All shoulder dislocations in patients aged 16 or over
Exclusions: Dislocations associated with greater tuberosity fractures, humeral and/or clavicular fractures, and children
Audits
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1st August 2009
Results
| Date | Patients | Measured | Results | Standard | Regional avg. |
|---|---|---|---|---|---|
| 01st August 2009 | Patients aged 16 or over presenting to the ED with shoulder dislocations. Exclusions - Dislocations associated with greater tuberosity fractures, humeral and/or clavicular fractures, and children. | Management of the patients according to the criteria. | X ray taken within 60 mins of arrival | 100 % | 92 % |
| X-ray post reduction | 100 % | 100 % | |||
| Two medical staff involved, one for reduction , one for sedation | 100 % | 60 % | |||
| Pain relief within 20 mins of arrival | 100 % | 72 % | |||
| Neurovascular examination (including axillary nerve) documented | 100 % | 96 % |
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