It's a typical busy post-Thanksgiving shift in the ED. It seems like patients with acute decompensated heart failure, sepsis, NSTEMI's and a whole host of other ailments are tucked in every corner and crevice of the ED. Just as you finish putting in orders on the last patient you saw, your next patient rolls by on an EMS stretcher. You see from your computer that the patient is on a backboard and in a c-collar after what clearly was some form of traumatic event. He's screaming in pain and holding his left leg flexed at the hip and internally rotated. "Jeez, I bet that hip is dislocated," you say to yourself.
You know you're going to need to reduce this dislocation, to not do so would risk avascular necrosis. Tammy, one of the nurses you are working with that day is already 2 steps ahead of you. "Doc, we're getting everything set up for the sedation, you're going to need for that hip that's out. What drugs do you want us to pull up?"Read More