School of Medicine and Health Sciences Poster Presentations

Title

Opioid Utilization for Shoulder Dislocations in Emergency Department

Document Type

Poster

Abstract Category

Clinical Specialties

Keywords

opioid, dislocation, opioid crisis, emergency

Publication Date

Spring 5-1-2019

Abstract

United States Emergency Departments (EDs) frequently see closed shoulder dislocations. There is no standard analgesia for pre-reduction, reduction, and post-reduction pain in patients and pain is typically treated by physician preference. It is largely unknown how many patients with shoulder dislocations receive opioids in the ED or receive a home opioid prescription for post-reduction pain. Our purpose is to discover in what proportions various medication classes were utilized during shoulder dislocation-related ED visits and to analyze prescribing trends in the ED. This is a retrospective analysis from a nationally representative sample of US EDs from the Center for Disease Control's National Hospital Ambulatory Care Survey between 2005-15. All patient visits related to closed shoulder dislocations were identified and analyzed. CDC codes were used to identify the prescriptions of opioid analgesics, NSAIDS, muscle relaxers, and local anesthetics. 2.2 million shoulder dislocation ED visits were documented between 2005-2015. In total, 69.4% of patients were under 44 years (95% CI 63.85-74.95), and 74.1% were male (95% CI 69.0-78.9). The majority, 69.6% (95% CI 62.7-75.8), received opioids while in the ED, with 45.5% (95% CI 39.2-51.9) of patients receiving an opioid as their first medication. In addition, 41.3% (95% CI 35.8-47.1) received opioids as discharge prescription. Concurrently, 38.2% (95% CI 31.7-45.1) of patients were administered NSAIDS, 11.3% received muscle relaxers (95% CI 8.1-15.4) and 3.3% (95% CI 1.6-4.66) received lidocaine injections. Most visits related to closed shoulder-dislocations received opioid in the ED with nearly half receiving a home prescription. In comparison to patients with shoulder dislocations who did not receive opioids, there was no significant difference in age or gender, pain scale at triage, triage level, wait time to see a provider, or length of stay in the ED. NSAIDs, muscle relaxers and lidocaine injections were comparatively underutilized.

Open Access

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Presented at Research Days 2019.

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Opioid Utilization for Shoulder Dislocations in Emergency Department

United States Emergency Departments (EDs) frequently see closed shoulder dislocations. There is no standard analgesia for pre-reduction, reduction, and post-reduction pain in patients and pain is typically treated by physician preference. It is largely unknown how many patients with shoulder dislocations receive opioids in the ED or receive a home opioid prescription for post-reduction pain. Our purpose is to discover in what proportions various medication classes were utilized during shoulder dislocation-related ED visits and to analyze prescribing trends in the ED. This is a retrospective analysis from a nationally representative sample of US EDs from the Center for Disease Control's National Hospital Ambulatory Care Survey between 2005-15. All patient visits related to closed shoulder dislocations were identified and analyzed. CDC codes were used to identify the prescriptions of opioid analgesics, NSAIDS, muscle relaxers, and local anesthetics. 2.2 million shoulder dislocation ED visits were documented between 2005-2015. In total, 69.4% of patients were under 44 years (95% CI 63.85-74.95), and 74.1% were male (95% CI 69.0-78.9). The majority, 69.6% (95% CI 62.7-75.8), received opioids while in the ED, with 45.5% (95% CI 39.2-51.9) of patients receiving an opioid as their first medication. In addition, 41.3% (95% CI 35.8-47.1) received opioids as discharge prescription. Concurrently, 38.2% (95% CI 31.7-45.1) of patients were administered NSAIDS, 11.3% received muscle relaxers (95% CI 8.1-15.4) and 3.3% (95% CI 1.6-4.66) received lidocaine injections. Most visits related to closed shoulder-dislocations received opioid in the ED with nearly half receiving a home prescription. In comparison to patients with shoulder dislocations who did not receive opioids, there was no significant difference in age or gender, pain scale at triage, triage level, wait time to see a provider, or length of stay in the ED. NSAIDs, muscle relaxers and lidocaine injections were comparatively underutilized.