Hello! I'm hoping you can answer my question: in the event of a combination grade III separated shoulder and anterior dislocation with torn muscles, what are the on-site medics going to be most concerned with treating as they get the patient ready for transport to a hospital, (assuming precautions for head and spinal trauma have already been taken) Any reference sites/articles about treatment and/or recovery would also be appreciated. Thank you!
This is less about the specific injury as it is “what the medics would do”.
EMTs and paramedics (in the US, though I assume elsewhere as well) are primarily concerned with keeping their patient alive until they get to the hospital and can hand them off to a higher level of care. They’re trained for this and really good at it.
Dislocated shoulders/shoulder injuries in general are typically not life threatening. As you alluded to with the head/spinal trauma precautions, though, things that cause them (falls, fights, etc..) also cause other injuries that could be life threatening, so finding those things is the highest priority.
The medic or EMT is going to go through their normal trauma assessment to find any other possible injuries (pat the patient down, expose skin, look for blood, determine level of consciousness, etc..), attempt to take a basic medical history if the person is awake and can give it to them (get information on symptoms, allergies, medications, medical conditions the patient has, most recent intake/output, and what caused the injury), and take vital signs. This is all essentially looking for problems that could kill them that might be obscured by the pain of the shoulder.
Assuming the patient is otherwise stable, they’ll put them in a position of comfort and transport them to a hospital emergency department. They’re not going to do a whole lot of treatment besides maybe give pain medication or start an IV (if medics). Any dislocation bad enough to need the emergency department will need imaging (x-rays, possibly CT scan) and reduction (setting) or even surgery in a hospital setting. This is above a US paramedic’s scope.
