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Strangulated small bowel obstruction — RCPSC EM MCQ

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HardGI/Abdominal emergenciesStrangulated small bowel obstructionRCPSC EM

A 25-year-old has a first anterior shoulder dislocation without fracture after a rugby tackle. Distal perfusion and axillary sensation are intact. What is the most appropriate next step?

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Correct answer: E — Provide analgesia and reduce the shoulder with neurovascular reassessment

The best answer is “Provide analgesia and reduce the shoulder with neurovascular reassessment”. An uncomplicated anterior dislocation should be reduced promptly after neurovascular assessment and appropriate analgesia or anaesthesia. Delay reduces success and increases discomfort. Reassess and document neurovascular status after reduction, confirm position as indicated and provide sling and follow-up; MRI and surgery are not routine prerequisites.

Reference: Emergency Care BC: Shoulder Dislocation: https://emergencycarebc.ca/clinical_resource/clinical-summary/shoulder-dislocation/