| Show Learning Points most relevant to Phase 1: |
Dislocated joint
| Clinical Discipline(s)/Organ System(s) Emergency Medicine, Musculoskeletal System, Orthopaedics | Progress Test Topic(s) Musculoskeletal |
Description
A 23 year old Samoan man attends the Emergency Department after dislocating his shoulder playing rugby. His friend who is a doctor has tried unsuccessfully to relocate the shoulder. The emergency nurse practitioner is managing the case and you are helping them.
Progress Test-Type Questions: Question 1Applied Science for Medicine
- Anatomy of the upper limb, including nerve and vascular structures at risk
- Function of the rotator cuff
- Aetiology of shoulder dislocations
- Bankart and Hill-Sachs lesions
- Pharmacology of paracetamol, non-steroidal anti-inflammatory drugs, codeine, tramadol, pethidine, benzodiazepines, midazolam and fentanyl
- Anatomy of the upper limb, including nerve and vascular structures at risk
- Function of the rotator cuff
- Aetiology of shoulder dislocations
- Bankart and Hill-Sachs lesions
- Pharmacology of paracetamol, non-steroidal anti-inflammatory drugs, codeine, tramadol, pethidine, benzodiazepines, midazolam and fentanyl
Clinical and Communication Skills
- History from a patient with acute limb injury
- Examine the limbs, test rotator cuff function and recognise a dislocated joint
- Differential diagnosis of shoulder dislocation
- Interpret shoulder X-ray
- Indications for CT shoulder, MRI shoulder, arthroscopy
- Management of anterior, posterior and inferior dislocation of the shoulder
- Complications of shoulder dislocation
- Methods for preventing further dislocation
- Prognosis of shoulder dislocation
- Role of the emergency nurse practitioner, physiotherapist
- History from a patient with acute limb injury
- Examine the limbs, test rotator cuff function and recognise a dislocated joint
- Differential diagnosis of shoulder dislocation
- Interpret shoulder X-ray
- Indications for CT shoulder, MRI shoulder, arthroscopy
- Management of anterior, posterior and inferior dislocation of the shoulder
- Complications of shoulder dislocation
- Methods for preventing further dislocation
- Prognosis of shoulder dislocation
- Role of the emergency nurse practitioner, physiotherapist
Personal and Professional Skills
- Treatment of self and personal contacts
- Patient education
- Role of the Accident Compensation Corporation
- Treatment of self and personal contacts
- Patient education
- Role of the Accident Compensation Corporation
Hauora Māori
- Differential ACC claims and rehabilitation for Māori vs non-Māori (for injuries in general)
- Differential impact on employment/income for Māori
- Differential ACC claims and rehabilitation for Māori vs non-Māori (for injuries in general)
- Differential impact on employment/income for Māori
Population Health
- Epidemiology of shoulder dislocation
- Epidemiology of injuries for the major sports in New Zealand
- Epidemiology of shoulder dislocation
- Epidemiology of injuries for the major sports in New Zealand
Conditions to be considered relating to this scenario
Common
anterior shoulder dislocation / instability
anterior shoulder dislocation / instability
Less common but 'important not to miss'
axillary artery / nerve injury, brachial plexus injury, post-ictal dislocation, post-electrocution dislocation
axillary artery / nerve injury, brachial plexus injury, post-ictal dislocation, post-electrocution dislocation
Uncommon
posterior shoulder instability / dislocation
posterior shoulder instability / dislocation
