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A 35-year-old male patient presents to the ED with anterior

A 35-year-old male patient presents to the ED with anterior dislocation of left shoulder. He was wrestling (horseplay) while at work at a heavy truck body shop and his arm was twisted out of its socket by his opponent. He appears in good spirits but is in pain, and would like to undergo moderate sedation for the reduction procedure. Risks and benefits of the procedure explained. Moderate sedation was achieved using Ketamine, and the dislocation reduction took approximately 30 minutes due to difficulty in determining if the joint was back in place. E/M encounter involved comprehensive history and examination with high complexity MDM performed.

 
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