Have you ever wondered how a dislocated hip can be reduced? In this video, we will discuss the Captain Morgan technique for the reduction of a hip dislocation. This technique is named after the pirate on the Captain Morgan rum bottle, who has his leg up on a barrel in a rather classic pose.
Before we begin, it's important to note that reducing a dislocated hip can be a physically challenging procedure.
However, if done with good technique, it can be a much more successful and less challenging endeavor.
Preparations for hip reduction involve assembling essential equipment, which includes a stretcher and a bed sheet, establishing an intravenous route for medication administration, choosing between Propofol or etomidate for sedation, and ensuring the presence of BP, ECG, and SpO2 monitors for continuous patient monitoring.
Additionally, airway and oxygen devices are prepared to ensure the patient's safety and well-being during the procedure.
First, the patient's hips and pelvis must be anchored to the stretcher.
If the hips and pelvis not anchored to the stretcher, the patient's body will be lifted off the stretcher when you try and elevate the leg to reduce the hip.
To do this, a sheet is placed over the pelvis itself and anchored to the stretcher.
Here are the steps for the Captain Morgan technique:
Attach to monitors, give O2 mask, and then sedate the patient.
Position the patient so that the hip and knee are in 90-degree flexion.
Step one of your feet up onto the gurney in the Captain-Morgan style.
Position your knee behind the patient’s knee.
Your foot should be resting on a hard surface such as a backboard or a hard-cover book, in order to allow your foot to push off of it.
Use one hand to lift up on the patient’s thigh.
Plantar-flex your ankle so that your propped knee can lift up on the patient’s knee.
Gently use the other hand to leverage-down on against the patient’s shin. In difficult cases, try internal and external rotation of the hip while lifting.
Remember to keep a steady sustained force, just like any large joint reduction.
Once you’re lifting, keep a steady sustained force, no jerking or sudden movements.
Also, make sure to tuck your knee tightly under the patient’s knee so that when you lift up on your tiptoes, all the force is transmitted into lifting the patient’s hip.
If your leg is much shorter than your patient’s leg, you may need to put a book under your foot to get your knee tucked under theirs.
The Captain Morgan technique is a novel technique for the reduction of a hip dislocation.
Physicians should consider this method a primary technique for the acute management of hip dislocation in the emergency department.