Acil Serviste Omuz Çıkıklarının Değerlendirilmesi: Sedoanaljezi ve İzlem

Abstract

Glenohumoral joint is the most mobile joint in the body and its dislocation is the most frequently seen large joint dislocation in the emergency department. Pain relief and overcoming muscle resistance are keys to a successful reduction. Although a reduction with an appropriate sedoanalgesia prolongs the hospital stay, it improves the success of the procedure and the patient’s comfort. The aims of this study are to investigate the lengths of stay at the emergency department for the patients, who had dislocation diagnosis and reduction procedure, and the success of emergency department physicians in reduction procedures. The cases of the patients, who admitted to Eskisehir Osmangazi University School of Medicine, department of emergency medicine between 01.03.2011 and 01.03.2013, were identified as S40-S49 pursuant to ICD 10 coding system, and were over 18 years of age, were browsed retrospectively. The epidemiologic data of the patients, the applied analgesia and the sedation types, the clinic which administered them and their success rates were recorded. The collected data were evaluated statistically. Of 103 patients included to the study, 85 patients (82.5%) were male and their average age was 37.62 ± 16.93. Of 73 patients for whom the emergency physician tried closed reduction, the procedure was successful and there were no complications in 68 (93.1%). When the lengths of stay at the emergency department were compared in patients administered sedation and those not, it was detected that the patients who had sedation stayed significantly longer at the emergency department (p=0.001). It was detected that the patients stayed significantly shorter at the emergency department even though they had sedoanalgesia (p<0.001), when the reduction procedures were performed by the emergency physicians. Sedoanalgesia administered for shoulder reduction prolongs the patients’ lengths of stay at the emergency department. However, the application of shoulder reduction with sedoanalgesia in a fitting patient group by emergency department physicians would improve success rate and decrease unnecessary consultations, pain and anxiety in patients, and their lengths of stay at the emergency department.