Anterior glenohumeral dislocations: Utilization of the Oxford Chair Technique of reduction by Emergency Nurse Practitioners

SummaryBackgroundThere are numerous methods described to reduce anterior glenohumeral dislocations with varying levels of success rates of reduction. Conscious sedation is often used for the reduction resulting in long periods of stay in already overstretched Emergency Departments. Reduction is traditionally performed by Senior Medical Officers.MethodsA prospective cohort study was undertaken. Patients presenting with a glenohumeral dislocation between May 2008 and May 2009 were identified by clinical diagnosis or by X-ray. Patients were managed by an Emergency Nurse Practitioner when they were on shift.The main objective was to examine whether Emergency Nurse Practitioners can, using a simple conscious sedation free technique of reduction called the Oxford Chair Technique, reduce anterior glenohumeral dislocations. Subsequent objectives measured were in terms of times of treatment.ResultsOf the 23 attempts to reduce a glenohumeral dislocation by an Emergency Nurse Practitioner 83% (n = 19) had their dislocation successfully reduced. The mean time of reduction was 6 min. Of the successful reductions using the Oxford Chair Technique, the minimal arrival to discharge time was 45 min and the median arrival to discharge time was 94 min.Of the patients successfully treated with the Oxford Chair Technique, 47% (n = 9) had experienced their first glenohumeral dislocation. Other demographic data collected provided evidence that the Oxford Chair Technique can be successfully used on a wide age range (18–76) and for either sex with 74% of successful reductions being men. No complications/adverse events or incidents were reported using the Oxford Chair Technique.ConclusionThis study has provided evidence that Emergency Nurse Practitioners can safely and independently reduce anterior glenohumeral dislocations using the Oxford Chair Technique. When reduction was successful there were time saving benefits to the patient with subsequent logistical benefits to the Emergency Department.