Rowley Cottingham wrote:
>> I'd agree with that statement. A recurrent anterior dislocation not
>> associated with trauma can be treated prior to X ray. Has anyone had a
>> problem doing this?
>>
>> Ray McGlone
>> A&E Lancaster
>I do. It sets something of a precedent. Not for me, you understand - I >popped
one back the other day. However, I think I have told the tale of >the Consultant
surgeon hauling on his son's shoulder convinced it was >dislocated and it was
not. Whole heap of issues there, but essentially >if he couldn't diagnose it
an SHO should not be allowed to treat without >X-ray.
>I know it smacks of do as I say not do as I do, but these guys need >protection.
>Best wishes,
>Rowley Cottingham
I understand , but for the sake of the argument let me ask: what makes you different
from a consultant surgeon? Experience, you might reply. Then, if one knows how
to diagnose an anterior dislocation and there is no history of trauma, why X-Ray?
OK, an inexperienced SHO who has, maybe, seen one or two dislocated shoulders
might not be able to make that diagnosis (and could well be unable to interpret
the X-Ray, too). In the majority of cases, though, there will be a senior doctor
around who can quickly decide whether to X-Ray or not, saving the patient time
(and minimizing the pain).
Post reduction, I always X-Ray.
Marcello della Corte
Staff Grade
Emergency Department
Oxford
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