Dr Neil Cunningham (MBBS, FACEM) works at St. Vincent’s Hospital in Melbourne, Australia. He combines his two passions of Emergency Medicine and Education with his roles as an Emergency Staff Specialist, Simulation Instructor and Supervisor of pre-vocational training for the junior doctors at St. Vincent’s.
Neil has a special interest in shoulder dislocations, developing a new reduction method known as the Cunningham Technique. This was published in 2003 and then followed up in 2005 with a review paper of shoulder relocation techniques classified from an anatomical / biomechanical standpoint. This included his modification of the classic Milch method, which incorporated Saha’s concept of the “zero position”.
He aims to promote the use of anatomically-based non-traction relocation techniques in order to improve the care of patients with a shoulder dislocation who present to hospital, or in an out-of-hospital setting where sedation or analgesia is not an option, such as in rural areas, clinics or sports fields.
His technique has appeared in Dunn’s “The Emergency Medicine Manual” and the latest edition of AccessMedicine – “Tintinalli’s Emergency Medicine: A Comprehensive Study Guide.” The Cunningham Technique has also featured in the emergency medicine blogs Life In The Fast Lane and TheCentralLine.Org. Neil has recently been interviewed by Emergency Medicine News and will feature in an upcoming edition of EM-RAP.
Neil’s other passion is education with a particular interest in educational debriefing, both in Simulation and on-the-floor clinical teaching scenarios.
Dr Gerard Fennessy (MBChB, PGDipCEM) is an advanced trainee in Intensive Care and Emergency Medicine, currently being a home dad in Warrnambool, Australia.
Gerard developed an interest in shoulder dislocations whilst working on Mt Ruapehu Skifield, New Zealand. As a skifield doctor he was regularly required to attend to shoulder dislocations, which occurred about 5 times per week during the winter season. His initial technique was sedation with traction-countertraction.
After reading the article on the Cunningham Technique, he and his counterpart (Dr Tessa Pirie) changed their practice, and this became their technique of choice, with an almost 100% success rate, including 2 posterior dislocations. He no longer practices traction-countertraction.
He completed a postgraduate diploma in community emergency medicine in 2007 (Auckland, NZ), gaining a fellowship in AMPA. He has also worked as a medicolegal advisor, a cruise ship doctor and was a demonstrator for Neil’s shoulder dislocation workshop at the ACEM scientific meeting in 2009. He has an interest in the psychology of pain relief, particularly in those who present to the emergency department with acute pain.
He also writes as a guest author on Life In The Fast Lane, a web-blog dedicated to education of emergency and intensive care physicians, with blogs on therapeutic hypothermia, ECG axis interpretation, colchicine overdose, and many others.
There are several important people we have to thank without whom this website would not exist.
We are immensely grateful to all of the patients who feature in our photographs and videos and who kindly agreed to us using the images for educational purposes on our website. They consented both before and after having their shoulders relocated!
Dr Tom Huang dedicated his time and photographic expertise and provided many of the original images for the techniques and also the Cunningham Technique animation. We are indebted to him for creating the first iteration of this website. Tom combines being a doctor with freelance photography and you can find more of his work at http://www.tomhuangphotography.com/.
We would like to thank our hospital colleagues and friends who agreed to bare their shoulders, all in the name of medicine.
We are grateful to Mike Cadogan from Frontier Group, the Global Medical Education Project, and Free Open Access Medicine for their hosting support, an Chris Dobbin from Qube Group for the website design and advice.
To the many people who have corresponded over the years, who have found shoulder reductions fascinating, frustrating and satisfying, we have been deeply inspired by your feedback and experiences. The exchange of medical knowledge with peers all over the world was the impetus for the production of this website and continues to be one of the most exciting aspects of our work on shoulder dislocations.
Last but definitely not least – we thank our wonderful wives who provide enduring support, keen-eyed criticism and much needed quality control.