National athletic trainers' Association position statement: Immediate management of appendicular joint dislocations

Objective: To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations. Background: One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment. The critical concern in managing a dislocation is deciding when a joint can be reduced onsite and when the patient should be splinted and transported for reduction to be performed in the hospital or medical setting. Factors that influence the decision-making process include the following: whether the AT possesses a documented protocol that is supported by his or her supervising physician(s), employer documents, and respective state regulations; the AT's qualifications and experience; the dislocated joint; whether the dislocation is first time or recurrent; the patient's age and general health; and whether associated injuries are present. Recommendations: These guidelines are intended to provide considerations for the initial care of specific joint dislocations. They are not intended to represent the standard of care and should not be interpreted as a standard of care for therapeutic or legal discussion.