Pediatric emergency medicine trisk 0866 0866

prior to the emergency department evaluation Cervical spine injuries must be excluded, which if clinically indicated, may include imaging FIGURE 43.5 Burner/stinger syndrome As in a football tackle, the shoulder is depressed while the head and neck are pushed away from the affected shoulder, resulting in a stinger This same mechanism, combined with extension of the neck, may result in compression of the nerves on the contralateral shoulder, also resulting in a burner or stinger (Reprinted with permission from Miniaci A Disorders of the Shoulder: Sports Injuries Philadelphia, PA: Lippincott Williams & Wilkins; 2013.) EVALUATION AND DECISION Initially, the patient’s neurovascular status is assessed and fracture stabilization provided, if necessary (see Fig 43.6 ) For an isolated shoulder injury, ask the patient to localize the pain as specifically as possible Determine both the mechanism and the shoulder position during injury If the pain is chronic, determine the position or motion that most