title: 'A torn shoulder': an emergency department case study.
abstract: BACKGROUND
  Rupture of the biceps is not a very common presentation to the emergency departments; as a result, it is poorly documented, especially in nursing literature. It is important that these patients are appropriately managed by registered advanced nurse practitioners. As the diagnosis of rupture is usually made on clinical grounds with imaging assisting in the diagnosis, left untreated these injuries can lead to considerable functional deficits.
  
  
  METHODS
  The following paper is a case study based on a patient who presented to the emergency department with a proximal biceps rupture following trauma. The paper focuses on the clinical assessment and management of patients who present to the emergency department with these injuries.
  
  
  RESULTS
  This case study increases awareness of bicep ruptures and its management in the ED. Discussion points include the neurovascular assessment of these patients, the appropriateness of diagnostic imaging, and in-depth clinical examination techniques.
  
  
  CONCLUSIONS
  Rupture of the biceps tendon is often a result of a sudden forceful extension of the elbow against a previously contracted biceps and flexed elbow. The patient often describes a popping noise and presents with a 'popeye' deformity over their biceps. It is important to be vigilant with these injuries as early recognition will optimise the patients' outcomes.
authors.affiliation: Emergency Department, Our Lady's Hospital, Navan, County Meath, Ireland; School of Nursing, Midwifery and Health Systems, University College Dublin (UCD), Dublin, Ireland. Electronic address: lynda.gibbons@hse.ie.
authors.forename: Lynda
authors.initials: L
authors.lastname: Gibbons
mesh_terms: D001132:Arm / Q000473:pathology*; D000070632:Hamstring Tendons / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture / Q000175:diagnosis* / Q000628:therapy; D012782:Shoulder / Q000473:pathology
keywords: Advanced practice; Biceps rupture; Biceps tear; Case study; Emergency department; Popeye deformity; Proximal biceps