Author: Olivia Jones, William Wilson / Editor: Tim Osborne / Codes: / Published: 02/04/2025
A 27-year-old woman presents to the Emergency Department (ED) having sustained a fall while playing volleyball and landed awkwardly on her right shoulder. She is complaining of right shoulder pain with obvious deformity and informs you that this has happened before. She has received 10mg of intravenous morphine in the ambulance prior to arrival.
The patient has a history of well-controlled asthma and is otherwise fit and well. Vital signs: respiratory rate (RR) 24, oxygen saturations 98% on air, blood pressure (BP)108/67, heart rate (HR) 115, temperature 36.4.
On examination she has an obvious right shoulder deformity with localized tenderness and reduced range of movement. Radial and ulnar pulses palpable. Sensation intact. X-ray confirms an anterior shoulder dislocation.
Despite the above analgesia the patient continues to complain of severe pain and is visibly distressed.
You consider whether to administer one inhaler device of Penthrox for pain relief.
