Safety and Efficacy of Attempts to Reduce Shoulder Dislocations by Non-medical Personnel in the Wilderness Setting

Objective The objectives of this study were to explore the success rate and the complication rate for shoulder reduction attempts by non-medical personnel in the wilderness setting, and to compare the average time to reduction for those done on scene versus those that waited for reduction at a medic...

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Veröffentlicht in:Wilderness & environmental medicine 2010-12, Vol.21 (4), p.357-361.e2
Hauptverfasser: Ditty, Jack, Chisholm, Dugald, Davis, Stephen M., Estelle-Schmidt, Mary
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container_end_page 361.e2
container_issue 4
container_start_page 357
container_title Wilderness & environmental medicine
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creator Ditty, Jack
Chisholm, Dugald
Davis, Stephen M.
Estelle-Schmidt, Mary
description Objective The objectives of this study were to explore the success rate and the complication rate for shoulder reduction attempts by non-medical personnel in the wilderness setting, and to compare the average time to reduction for those done on scene versus those that waited for reduction at a medical facility. Methods In this study we solicited online survey responses from users of wilderness sports forums between October 2008 and April 2009. These surveys asked respondents to describe previous wilderness sports injuries they experienced. Descriptive statistics were calculated, and the Mann-Whitney U test was used to compare average reduction times, with an alpha of .05 selected as the significance threshold. Results Overall, there were 112 responses with 56 describing shoulder dislocations that were reduced either on scene or at a medical facility. Reduction on scene, in the absence of a medically trained person, was attempted in 39 of these 56 cases with a success rate of 71.8% (28/39). The median time to reduction on scene was 5 minutes, compared to 135 minutes from the time of injury for those that were reduced at a medical facility ( P
doi_str_mv 10.1016/j.wem.2010.06.010
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Methods In this study we solicited online survey responses from users of wilderness sports forums between October 2008 and April 2009. These surveys asked respondents to describe previous wilderness sports injuries they experienced. Descriptive statistics were calculated, and the Mann-Whitney U test was used to compare average reduction times, with an alpha of .05 selected as the significance threshold. Results Overall, there were 112 responses with 56 describing shoulder dislocations that were reduced either on scene or at a medical facility. Reduction on scene, in the absence of a medically trained person, was attempted in 39 of these 56 cases with a success rate of 71.8% (28/39). The median time to reduction on scene was 5 minutes, compared to 135 minutes from the time of injury for those that were reduced at a medical facility ( P &lt;.001). Other than pain during the reduction, there were no reports of serious complications associated with the reduction attempts. Conclusions These data suggest that reduction of dislocations in the wilderness setting by non-medical personnel may be safe and effective, and significantly decreases the time to reduction. These findings may help guide future instruction of participants in high-risk wilderness sports.</description><identifier>ISSN: 1080-6032</identifier><identifier>EISSN: 1545-1534</identifier><identifier>DOI: 10.1016/j.wem.2010.06.010</identifier><identifier>PMID: 21168791</identifier><language>eng</language><publisher>Los Angeles, CA: Elsevier Inc</publisher><subject>Athletic Injuries - epidemiology ; Athletic Injuries - prevention &amp; control ; Athletic Injuries - therapy ; Emergency ; Emergency Service, Hospital ; First Aid - methods ; First Aid - statistics &amp; numerical data ; Health Personnel ; Humans ; Internet ; Manipulation, Orthopedic - methods ; reduction ; shoulder dislocation ; Shoulder Dislocation - epidemiology ; Shoulder Dislocation - prevention &amp; control ; Shoulder Dislocation - therapy ; Surveys and Questionnaires ; Treatment Outcome ; Wilderness ; wilderness medicine</subject><ispartof>Wilderness &amp; environmental medicine, 2010-12, Vol.21 (4), p.357-361.e2</ispartof><rights>Wilderness Medical Society</rights><rights>2010 Wilderness Medical Society</rights><rights>The Author(s) 2010</rights><rights>Copyright © 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Allen Press Publishing Services Winter 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-7352f5d99ad409bf7fda3495865564da90a1d44a63f69990e681c1d3cd4d75b03</citedby><cites>FETCH-LOGICAL-c516t-7352f5d99ad409bf7fda3495865564da90a1d44a63f69990e681c1d3cd4d75b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1016/j.wem.2010.06.010$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/847017766?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,21819,27924,27925,43621,43622,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21168791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ditty, Jack</creatorcontrib><creatorcontrib>Chisholm, Dugald</creatorcontrib><creatorcontrib>Davis, Stephen M.</creatorcontrib><creatorcontrib>Estelle-Schmidt, Mary</creatorcontrib><title>Safety and Efficacy of Attempts to Reduce Shoulder Dislocations by Non-medical Personnel in the Wilderness Setting</title><title>Wilderness &amp; environmental medicine</title><addtitle>Wilderness Environ Med</addtitle><description>Objective The objectives of this study were to explore the success rate and the complication rate for shoulder reduction attempts by non-medical personnel in the wilderness setting, and to compare the average time to reduction for those done on scene versus those that waited for reduction at a medical facility. Methods In this study we solicited online survey responses from users of wilderness sports forums between October 2008 and April 2009. These surveys asked respondents to describe previous wilderness sports injuries they experienced. Descriptive statistics were calculated, and the Mann-Whitney U test was used to compare average reduction times, with an alpha of .05 selected as the significance threshold. Results Overall, there were 112 responses with 56 describing shoulder dislocations that were reduced either on scene or at a medical facility. Reduction on scene, in the absence of a medically trained person, was attempted in 39 of these 56 cases with a success rate of 71.8% (28/39). The median time to reduction on scene was 5 minutes, compared to 135 minutes from the time of injury for those that were reduced at a medical facility ( P &lt;.001). Other than pain during the reduction, there were no reports of serious complications associated with the reduction attempts. Conclusions These data suggest that reduction of dislocations in the wilderness setting by non-medical personnel may be safe and effective, and significantly decreases the time to reduction. 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environmental medicine</jtitle><addtitle>Wilderness Environ Med</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>21</volume><issue>4</issue><spage>357</spage><epage>361.e2</epage><pages>357-361.e2</pages><issn>1080-6032</issn><eissn>1545-1534</eissn><abstract>Objective The objectives of this study were to explore the success rate and the complication rate for shoulder reduction attempts by non-medical personnel in the wilderness setting, and to compare the average time to reduction for those done on scene versus those that waited for reduction at a medical facility. Methods In this study we solicited online survey responses from users of wilderness sports forums between October 2008 and April 2009. These surveys asked respondents to describe previous wilderness sports injuries they experienced. Descriptive statistics were calculated, and the Mann-Whitney U test was used to compare average reduction times, with an alpha of .05 selected as the significance threshold. Results Overall, there were 112 responses with 56 describing shoulder dislocations that were reduced either on scene or at a medical facility. Reduction on scene, in the absence of a medically trained person, was attempted in 39 of these 56 cases with a success rate of 71.8% (28/39). The median time to reduction on scene was 5 minutes, compared to 135 minutes from the time of injury for those that were reduced at a medical facility ( P &lt;.001). Other than pain during the reduction, there were no reports of serious complications associated with the reduction attempts. Conclusions These data suggest that reduction of dislocations in the wilderness setting by non-medical personnel may be safe and effective, and significantly decreases the time to reduction. These findings may help guide future instruction of participants in high-risk wilderness sports.</abstract><cop>Los Angeles, CA</cop><pub>Elsevier Inc</pub><pmid>21168791</pmid><doi>10.1016/j.wem.2010.06.010</doi><oa>free_for_read</oa></addata></record>
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subjects Athletic Injuries - epidemiology
Athletic Injuries - prevention & control
Athletic Injuries - therapy
Emergency
Emergency Service, Hospital
First Aid - methods
First Aid - statistics & numerical data
Health Personnel
Humans
Internet
Manipulation, Orthopedic - methods
reduction
shoulder dislocation
Shoulder Dislocation - epidemiology
Shoulder Dislocation - prevention & control
Shoulder Dislocation - therapy
Surveys and Questionnaires
Treatment Outcome
Wilderness
wilderness medicine
title Safety and Efficacy of Attempts to Reduce Shoulder Dislocations by Non-medical Personnel in the Wilderness Setting
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