Reference
- Cunningham N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med (Fremantle). 2003;15(5-6):521-524.
Explore This Issue
ACEP Now: Vol 37 – No 08 – August 2018, ACEP Now: Vol 38 – No 07 – July 2019Pages: 1 2 3 | Single Page
6 Responses to “Incrementalization of the Cunningham Technique for Anterior Shoulder Reduction”
July 28, 2019
Frank FowerSounds wonderful, and Works Good.
I have been using the same Incriminating Engineering Since 1993 : though : I Call it Baby Steps
I have one Extra Step here : I massage the scapula and Trapezius while I am taking the patient about how to straighten and square their shoulders: then push the Tip
Lower Scapular Angle Medialy towards The Vertebral Column : then go to the front to sit and Proceed
Most of the Times: its Already Reduced : pain free
No Meds.
FrankFower MD, FACEP
July 28, 2019
Jeffrey FreemanLike most shoulder reduction techniques, an experienced operator has learned subtle improvements that improve their success in their hands. These incremental improvements are rarely published (as are few of the subtle clues to better procedures – hence the better outcomes for ‘experts’). Thanks for publishing these – there’s no question that a fast Cunningham expertly done is one of the easiest ways to put in a shoulder. I agree with the xray comments as well.
[I’m waiting for incrementalization of fecal impaction, chart documentation and getting out early….]
July 28, 2019
DAVID O JONESTried many times and it never works
July 29, 2019
Curtis Henderson, PhD, DO, FACEPThank you.
I have practice incrementalization unwittingly for decades of practice; I always called it superstition! I realized long ago if , after a few times of success, I engage a particular mindset (focus), set up exactly the same way and performed a procedure in a similar way , my success would continue. This would include laceration repair, LPs, intubation, procedural sedation, closed thoracostomy, fracture/dislocation reduction and the other many complicated intense actions we do. There is virtually no exception to this approach, but it takes time to learn this and to proceed with style and finesse. This article is pointed in its conclusions. I have not tried the Cunningham approach, but I will.
Regards
June 27, 2020
Marna GreenbergThe trick is to have the person assisting on the patient’s posterior to press gently medially on the lower scapular angle (it is really this that does the most , and similar to scapular manipulation reductions just doing it sitting up instead of prone)
October 20, 2020
Matt DiStefanoLike all things, the devil is the in details. You need to understand the anatomy, trust the process, and be patient. We have a case series that we’ll publish in 2021 of 183 shoulder reductions, 62% of which were accomplished via Cunningham technique. Rich you can contact me through casted.ca if you want to chat.