A dislocation is an injury in which a bone is moved out of its normal position in a joint. The most common examples of this are in the finger and the shoulder joints. Dislocations may also be associated with fractures of nearby bones.
Signs and symptoms
- Bruising or discoloration of the skin
- Deformity
- Loss of joint function—abnormal or no mobility
- Pain and tenderness
- Swelling
Management
- Reassure the person.
- Advise the person not to move and to support their injury in a position of least pain.
- Send for help and additional resources (first aid kit).
- Gain consent to provide (and document) treatment.
- Immobilise the injured limb in the position you found it in.
- Determine if an ambulance is required:
- press on the nearest fingernail/toenail to see if the blood circulation returns after applying pressure. Request an ambulance if there are signs of decreased circulation
- request an ambulance if the dislocation involves a major joint, e.g., shoulder or kneecap.
- Monitor and reassure the person where they fell or injured themselves if possible and safe to do so.
- Refer the person to a medical practitioner or continue to reassure the person while waiting for an ambulance to arrive.
✖ DO NOT
- attempt to reposition the dislocated joint or put a bone back in place
- give the person anything to eat or drink (nil by mouth)
- move the person until the joint has been immobilised, if safe to do so
- test the function of a suspected dislocation.
Note
- Absence of circulation constitutes a medical emergency. You should send for help and request an ambulance immediately.
- If possible, apply ice packs (covered by a towel or clothing) or cold compresses at irregular intervals over the site of injury for periods of 5–15 minutes to reduce pain and swelling.
- Treat for shock where appropriate (see Shock).
- A first responder qualified in providing pain management may also administer methoxyflurane for pain relief.