> I also come across a lot
> of patients who initially claim they will not tolerate anything except
being
> "knocked out" as the last time they had a dislocation, a junior SHO swung
> around as if they were in a tag-team wrestling match.
Hi Andy
Like you, a large proportion of patients I have seen with recurrent
dislocations have been extremely apprehensive due to previous painful
attempts at reduction, to the extent that they have a "dentist-like" phobia
of reduction! Unlike you, however, I don't remember any of them specifying
JUNIOR doctors as being the culprits. In my limited experience, I have seen
several forceful, painful attempts at reduction by senior doctors, whereas
junior doctors may have a nervous, inadequate wiggle before calling in the
senior big guns.
My guess is that the distinguishing factor between painful and painless
reducers of shoulders is compassion, patience and enough knowledge to be
flexible in your approach.
(just doing my bit for the under-represented junior A&E guys!)
Chris Kirke
|