Brian Doyle and Jacinta travelled to Geeveston for an early breakfast session with 4 of our very enthusiastic GPs from Geeveston and Dover. Brian’s session discussed shoulder dislocations and he introduced them to some more recent reduction techniques. These included the Milch technique, which has approximately an 80% success rate, the Cunningham technique and an external rotation technique. All of these are less forceful than the previous techniques that require sedation, traction and counter-traction. The GPs learnt that the most common shoulder dislocations are anterior but could expect the possibility of a posterior dislocation in a patient who has had a seizure or has been electrocuted.
Some techniques of relocation were also discussed and shown around finger and ankle dislocations. Brian outlined the effective use of intra-articular lignocaine into the ankle joint and the haematoma block that is more commonly used for forearm fractures. Brian was very excited to see that Geeveston had an ultrasound machine. He took advantage of the technology and showed off his ultrasound skills teaching some important tips on identifying fractures and tendon damage. Brian was definitely in his element here and the GPs were just as enthused.
Finally Brian led a discussion on analgesia and sedation and outlined the pros and cons of the use of morphine, ketamine, midazolam and fentanyl. Fentanyl came out on top as the favourite due to its ease of administration via intranasal method and having the least amount of side effects.
If you are keen on learning more about dislocations please ask Brian. He also suggested utilising ‘google’ that has some fantastic demonstrations on any of the techniques discussed above.
Some techniques of relocation were also discussed and shown around finger and ankle dislocations. Brian outlined the effective use of intra-articular lignocaine into the ankle joint and the haematoma block that is more commonly used for forearm fractures. Brian was very excited to see that Geeveston had an ultrasound machine. He took advantage of the technology and showed off his ultrasound skills teaching some important tips on identifying fractures and tendon damage. Brian was definitely in his element here and the GPs were just as enthused.
Finally Brian led a discussion on analgesia and sedation and outlined the pros and cons of the use of morphine, ketamine, midazolam and fentanyl. Fentanyl came out on top as the favourite due to its ease of administration via intranasal method and having the least amount of side effects.
If you are keen on learning more about dislocations please ask Brian. He also suggested utilising ‘google’ that has some fantastic demonstrations on any of the techniques discussed above.
