LAUSR

Anterior shoulder dislocations are the most common joint dislocation presenting to emergency departments (EDs). For a relatively simple problem, there is massive variation in the management of shoulder dislocations, including the decision to image before reduction, the reduction technique, and the method of immobilization.1 Perhaps the largest area of practice variation is in the management of pain, as some physicians reduce shoulder dislocations without any analgesics at all, while others rely on intravenous procedural sedation (IVS) or other analgesic techniques such as intraarticular anesthetic injections (IAA) or peripheral nerve blocks (PNB). Although significant adverse events are very rare with IVS, minor adverse events are relatively common, and IVS can be challenging in EDs habitually short on both staff and space.2 Therefore, there is growing interest in alternative techniques to control patients' pain during shoulder reductions. Here, we review the systematic review and metaanalysis published by Hayashi et al. in the October 2022 edition of Academic Emergency Medicine, providing critical analysis of the article and summarizing the social media discussion and a podcast in which the authors discuss their work.3 ARTICLE SUMMARY