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It is just after 16:30 hours and you are sent en route to the local high school for an injured soccer player. You receive an update on the way that your patient is a 17-year-old female with a possible lower leg fracture.
After arriving at the school, you’re guided by security to the soccer field, where you find your patient lying on the ground with a coach and a trainer at her side. She is in obvious discomfort.
As you approach you hear the trainer tell the patient to lie still. The coach jogs over to meet you and fills you in on the specifics of the injury.
The patient was dribbling the ball up the field and fell when another player collided with her. It appeared that she only injured her leg and she did not strike her head when she fell. She maintained consciousness the entire time.
When you reach the patient, you see that the trainer has already removed her shoes and shin guards. Her skin appears pink, warm and dry. She has an obvious deformity to her right lower leg. You introduce yourself and begin your history and physical assessment.
Patient assessment
The patient has no medical history and is not allergic to any medications. She confirms that she did not strike her head and had no loss of consciousness. Your physical exam confirms an isolated deformity to the right leg.
However, the patient does not appear to have pulses distal to the injury. The fracture appears to be halfway down her lower leg and is angulated at approximately 45 degrees.
Your partner is walking back to the ambulance for additional equipment and asks what you would like her to get. While you wait for your equipment, think about the following questions:
- What are the first steps you should take in stabilizing this patient?
- Where should the patient be transported to?
- Is there any additional treatment which should be provided?
Be sure to leave your answers in the comment section below.
