5-7.
IMMOBILIZE A DISLOCATED SHOULDER
A dislocation of the shoulder occurs when the head of the humerus is pushed out
of its socket at the shoulder. The dislocation can be either anterior (the head pushed
forward) or posterior (the head pushed backward). Most dislocations will be anterior
dislocations. Shoulder dislocations are painful and the casualty (if conscious) will
usually attempt to hold the arm on the injured arm to prevent movement. The shoulder
will not have its normal rounded appearance. Immobilize the injured shoulder and
upper arm without attempting to reduce the injury (replace the humerus in its socket).
a. Anterior Dislocation. If the head of the humerus is displaced toward the
casualty's front, the arm will be a fixed position away from the casualty's chest. Do not
try to reposition the arm as any attempt to move the arm toward the chest will produce
additional pain. Immobilize the arm in the extended position.
(1) Check the casualty's pulse below the dislocation. If no pulse is found,
evacuate the casualty as soon as possible after the arm is immobilized.
(2) Apply padding (a rolled blanket, pillow, or other material) between the
upper and the chest to fill the space between them.
(3)
Flex the elbow so the casualty's wrist is slightly higher than the elbow.
(4)
Apply a sling (arm sling number two) to support the forearm.
(5)
Apply a swathe to further immobilize the arm and to secure the padding
materials.
(6)
Evacuate the casualty in either a sitting position or laying on a litter.
b. Posterior Dislocation. If the head of the humerus is displaced toward the
casualty's back:
(1) Check the casualty's pulse below the dislocation. If no pulse is found,
evacuate the casualty as soon as possible after the arm is immobilized.
(2) Position the casualty's forearm across his midsection with his wrist
slightly higher than his elbow.
(3) Apply a sling to immobilize the arm. Use the arm sling number two
method to protect the shoulder from additional pressure.
(4)
Apply a swathe to further immobilize the arm.
(5)
Evacuate the casualty, either in sitting position or lying on a litter.
MD0533
5-12