Shoulder pain is a very common complaint during the summer time- people are active, working in their yards, etc. So when you are considering performing a shoulder injection for your patient. Where & What are you actually trying to treat? Is it bursitis, tendonitis, osteoarthritis flare, etc.?
Ok- so you get an xray.. Results: mild OA found.. now what? Well, how is the patient presenting? Is the shoulder their chief complaint- new or chronic pain? Did it present after trauma, activity, etc. ? Where is the pain located anterior, lateral shoulder? All these clues are extremely important in determining the exact condition of the shoulder pain in order to have the proper diagnosis and proper plan of care and what type of injection to perform.
Many providers (MDs, NPs & PAs) use the term "shoulder injection" to usually mean subacromial bursa injection- which is a different location than performing a (glenohumeral) shoulder joint injection- Seperate areas with seperate clinical indications (adhesive capsulitis is shared)
How bad would that be if you did everything correct, complications arouse anyway- the case went to court & was found that where you injected the shoulder had no clinical indication (wrong diagnosis). Your documentation with the wrong diagnosis would be blown up so big in the courtroom that people in China would see it. Your counsel would politely try to settle the case- the whole while muttering something about @#$% mid level providers...
So, it goes without saying- knowing the indications for each "shoulder" injection you perform is as important as where you are going to insert the needle.
All the best,
Andy Austin FNP-C
http://www.injectioncourses.com
Medical Procedures for Nurse Practitioners, Physicians and Physician Assistants
