Implementation of a Prehospital Patella Dislocation Reduction Protocol

Introduction: Acute patella dislocations account for up to 3% of all knee injuries. Prehospital care of patella dislocation often includes knee immobilization and pain management, but in the wilderness environment patella reductions are often performed by basic life support providers. Given the potential benefits of early reduction, the perceived low risk of harm and precedent with which the procedure can be performed, patella reduction was added to the EMT scope of practice in New York State. Our objective is to characterize the mechanism of patella related injuries and describe the success rate and complications experienced with the addition of a prehospital patella reduction protocol.Methods: This was a retrospective review of a voluntary, preexisting, quality assurance database of cases in which a patella reduction was attempted between October 1, 2016 and June 30, 2018.Results: 90 patients underwent an attempt at patella reduction at one of 52 EMS agencies during the study period. The most common mechanism was a sports-related injury. Patella reduction was successful 83/90 (92.2%). Median pain score was reduced from 10 to 2. There were no reported complications.Conclusion: While a convenience sample, our results provide preliminary evidence that patella reduction can be performed by EMS providers with infrequent complication and offers significant pain relief.