Hot take:

If you are regularly sedating patients for shoulder reductions, you're doing it wrong.

My steps, for patients with isolated shoulder complaint, concerning for dislocation (in a patient who is able to participate in their care and reduction)
1. Physical exam to confirm dislocation
2. PO Percocet + ibuprofen.
3. Xrays
4. Reduction
5. Xrays
6. Discharge

Xrays are important both to confirm that there are no other injuries and to help ortho folks during follow up.

No one is looking at your bedside ultrasound pictures, and they don't evaluate bone loss. Use it as an adjunct for reduction if you want, but not definitive imaging.

My preferred reduction technique is traction w/ scapular manipulation.

Have the patient lie prone on the stretcher with the affected arm off the side, hanging down.

This forces them to relax and isolate the shoulder.

The movements are easier with two people, but can be done with one.
Traction straight down to the floor.

Be gentle.

The patient gets some relief as soon as you disengage the humeral head from the edge of the glenoid.

Before you start traction, identify the scapula.

Then, start with arm traction.

Push on the lateral edge, rotating the inferior angle (the lower tip) medially. This moves the glenoid out of the way, allowing the humeral head to slide into place.