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Shoulder Dislocation in Emergency Medicine Treatment & Management

  • Author: Sharon R Wilson, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
Updated: Sep 15, 2015

Prehospital Care

In patients with shoulder dislocation, stabilize and treat associated trauma as indicated. Allow the patient to assume a position of comfort while maintaining cervical spine immobilization if necessary. A pillow between the patient's arm and torso may increase comfort.[18, 19]


Emergency Department Care

Administer analgesics to decrease pain.

Prereduction and postreduction radiographs are recommended. Patients with frequent recurrent dislocations can safely avoid radiographs.

Procedural sedation and analgesia (PSA) protocols, intra-articular lidocaine, and ultrasound-guided brachial plexus nerve block assist in making reduction an easier and more comfortable procedure. Using US-guided interscalene block reduces time spent in the ED and lessens one-on-one health care provider time compared to procedural sedation.[20]

Immobilize the shoulder after reduction.

Perform careful prereduction and postreduction neurovascular examinations.



Orthopedic consultation may be helpful for dislocations with concomitant fractures, for posterior or inferior dislocations, and for cases in which the patient's shoulder cannot be reduced in a timely fashion.

Contributor Information and Disclosures

Sharon R Wilson, MD Assistant Professor of Emergency Medicine, Department of Emergency Medicine, University of California at Davis Medical Center

Sharon R Wilson, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, American Association of University Women

Disclosure: Nothing to disclose.


Daniel D Price, MD Director of International Ultrasound, Department of Emergency Medicine, Alameda County Medical Center, Highland Hospital and Trauma Center

Daniel D Price, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

James E Keany, MD, FACEP Associate Medical Director, Emergency Services, Mission Hospital Regional Medical Center, Children's Hospital of Orange County at Mission

James E Keany, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, California Medical Association

Disclosure: Nothing to disclose.


Tom Scaletta, MD President, Smart-ER (; Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

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Y-view radiograph of the right shoulder shows anterior dislocation of the humeral head relative to the glenoid fossa.
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