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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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 <.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 & 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</subject><ispartof>Wilderness & 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 & 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 <.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><subject>Athletic Injuries - epidemiology</subject><subject>Athletic Injuries - prevention & control</subject><subject>Athletic Injuries - therapy</subject><subject>Emergency</subject><subject>Emergency Service, Hospital</subject><subject>First Aid - methods</subject><subject>First Aid - statistics & numerical data</subject><subject>Health Personnel</subject><subject>Humans</subject><subject>Internet</subject><subject>Manipulation, Orthopedic - methods</subject><subject>reduction</subject><subject>shoulder dislocation</subject><subject>Shoulder Dislocation - epidemiology</subject><subject>Shoulder Dislocation - prevention & control</subject><subject>Shoulder Dislocation - therapy</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><subject>Wilderness</subject><subject>wilderness medicine</subject><issn>1080-6032</issn><issn>1545-1534</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl1rFTEQhhdRbK3-AG8keOPVrsnmY3cRhFLrBxQVj-JlyEkmbY67yWmSVfbfm-VUC73o1STwPjPD-05VPSe4IZiI17vmD0xNi8sfi6aUB9Ux4YzXhFP2sLxxj2uBaXtUPUlph3HLekofV0ctIaLvBnJcxY2ykBekvEHn1jqt9IKCRac5w7TPCeWAvoGZNaDNVZhHAxG9c2kMWmUXfELbBX0Ovp7AFHZEXyGm4D2MyHmUrwD9dCvjISW0gZydv3xaPbJqTPDspp5UP96ffz_7WF98-fDp7PSi1pyIXHeUt5abYVCG4WFrO2sUZQPvBeeCGTVgRQxjSlArhmHAIHqiiaHaMNPxLaYn1atD330M1zOkLCeXNIyj8hDmJPsWd31xYVW-vKPchTn6spzsWYdJ1wlRROQg0jGkFMHKfXSTioskWK5xyJ0sccg1DomFLKUwL24az9vi0H_in_9F0BwESV3C7dT7Or45AFCc--0gyqQdeF3sj6CzNMHdS7-9Q-vR-TW4X7BAup0vUyux3KwHtN4PweV2cM_pX329vcw</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Ditty, Jack</creator><creator>Chisholm, Dugald</creator><creator>Davis, Stephen M.</creator><creator>Estelle-Schmidt, Mary</creator><general>Elsevier Inc</general><general>SAGE Publications</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PADUT</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>Safety and Efficacy of Attempts to Reduce Shoulder Dislocations by Non-medical Personnel in the Wilderness Setting</title><author>Ditty, Jack ; Chisholm, Dugald ; Davis, Stephen M. ; Estelle-Schmidt, Mary</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-7352f5d99ad409bf7fda3495865564da90a1d44a63f69990e681c1d3cd4d75b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Athletic Injuries - epidemiology</topic><topic>Athletic Injuries - prevention & control</topic><topic>Athletic Injuries - therapy</topic><topic>Emergency</topic><topic>Emergency Service, Hospital</topic><topic>First Aid - methods</topic><topic>First Aid - statistics & numerical data</topic><topic>Health Personnel</topic><topic>Humans</topic><topic>Internet</topic><topic>Manipulation, Orthopedic - methods</topic><topic>reduction</topic><topic>shoulder dislocation</topic><topic>Shoulder Dislocation - epidemiology</topic><topic>Shoulder Dislocation - prevention & control</topic><topic>Shoulder Dislocation - therapy</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><topic>Wilderness</topic><topic>wilderness medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ditty, Jack</creatorcontrib><creatorcontrib>Chisholm, Dugald</creatorcontrib><creatorcontrib>Davis, Stephen M.</creatorcontrib><creatorcontrib>Estelle-Schmidt, Mary</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Research Library China</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Wilderness & environmental medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ditty, Jack</au><au>Chisholm, Dugald</au><au>Davis, Stephen M.</au><au>Estelle-Schmidt, Mary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Efficacy of Attempts to Reduce Shoulder Dislocations by Non-medical Personnel in the Wilderness Setting</atitle><jtitle>Wilderness & 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 <.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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