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The following is a summary of “What should be documented for an anterior shoulder dislocation? A Delphi study,” published in the February 2025 issue of Emergency Medicine Journal by Naald et al.
Standardized, consensus-based documentation after anterior shoulder dislocation in the ED may enhance clinical quality, streamline research, and reduce workload.
Researchers conducted a retrospective study to identify key elements and assess variability in ED documentation following anterior shoulder dislocation.
They recruited an expert panel of emergency physicians who perform documentation and management of anterior shoulder dislocation and those who may read it (orthopaedic surgeons and general practitioners) for a 3-round Delphi study between May and November 2022. Key elements were identified for history, physical examination, additional examinations, reduction technique, and miscellaneous categories. Items were rated on a 0–9 Likert scale, with consensus defined as ≥80% scoring 7–9. High variability was independently assessed when at least 1 score ranged from 1–3 and another from 7–9 after the third round.
The results showed that the expert panel included 22 emergency physicians, 5 general practitioners, and 3 orthopaedic surgeons. In the first round, 85 elements were identified, with consensus on importance reached for 22 elements: medical history (5/30), physical examination (5/18), additional examinations (5/9), reduction (5/17), and miscellaneous (2/11). After the third round, high variability in importance was observed in 79 of 85 elements (93%).
Investigators concluded that a consensus was reached on 22 of 85 elements related to anterior shoulder dislocation, which could be included in ED documentation, although substantial variability in opinions regarding these elements was observed.
Source: emj.bmj.com/content/early/2025/02/17/emermed-2024-214347
