The FARES (FAst, REliable, and Safe) technique for shoulder reduction relies on the idea that muscle spasms and tension are keeping the shoulder from going back in. Therefore, the most important part of this technique is a gentle up-and-down oscillation of the shoulder while applying traction.
How to reduce a shoulder with the FARES technique
- Have the patient lay down on a stretcher with the affected arm close to the edge. Apply traction towards you while gently moving the arm up and down about 5 cm from the neutral position, with two up-and-down cycles per second.
- As you are pulling the arm towards you and oscillating up and down, start to slowly abduct the arm away from the patient’s side. Continue this technique until you’ve oscillated the arm to reach 90°of shoulder abduction. This may take over two minutes.
- While continuing to oscillate and abduct the arm, gently externally rotate the shoulder. You’ll feel a clunk when the shoulder pops back in place.
- The reduction usually happens by the time you get to 120° of abduction, but if it happens a little earlier, stop then.
- Once the shoulder is back in, gently internally rotate the shoulder and bring the forearm across the chest, with the affected hand touching the opposite shoulder.
You’re well on your way to mastering the FARES technique. Keep up the good work!
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