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Simple Knee Injury
Straight forward knee injury with no secondary complications

25 January 2019 - 01:16 | Version 1 | | |

Scenrio Name: Simple Knee Injury
Summary: Straight forward knee injury with no secondary complications
Primary Assessment:

  • ABCD's ok
  • no obvious severe bleeding
  • facial color and moisture, pulse, and the temperature, color, and moisture of the skin of her wrist all normal
  • mechanism of injury (fall, twisted knee) does not suggest the possibility of a serious injury
  • Did not hit head or go un-conscious.
  • Major complaint: knee hurts
Urgency: 3
Response: Splint knee
Script:
 You: "Hi, I'm Ben Schussen of the High Range Ski Patrol. Can I help you? What's your name?" 
While talking, you take off your skis and approach the girl. Patient: "Oh, I'm so glad to see you! My name is Eileen Ann Wintz. I fell and really hurt my knee." You : (Observing her face, noting that the skin is dry and ruddy from the cold):
"Excuse me a minute, Eileen. I'm going to put your skis up in the snow to warn uphill skiers to ski around us."
You form an upright X with the patient's skis uphill from the accident.
Then, you radio for a toboggan and return to the patient.
As you talk to the patient, you grasp her wrist and note that her pulse is strong, regular, and has a normal rate. Her breathing appears normal too. You : "You hurt your right knee?" Patient: "Yes. I was trying a turn, and one ski went one way and one went the other. I fell down between them." You : "Did your bindings release?" Patient: "Yes, both of them, but my knee twisted when I fell down." Yo u : "Did you feel a pop in your knee when you fell?" Patient: "No." By this time, you have established that Eileen's airway, breathing, circulation, and level of responsiveness are normal.
As you expected, there is no obvious severe bleeding. You have assessed her facial color and moisture, her pulse, and the temperature, color, and moisture of the skin of her wrist, all of which are normal.
The mechanism of injury does not suggest the possibility of a serious injury, but there are two more questions you need to ask. You: "Did you hurt your head, neck, or back when you fell?" Patient: "No." You: "Did you hurt yourself anywhere else?" Patient: "No." It is now time for you to assess the site of major complaint. You : "I've called for a toboggan so we can give you a ride down the hill. Let me put my jacket around you to keep you warm.
I'll also loosen your boots. While we're waiting, I'll take a look at your knee. Can you feel your toes okay?" (The patient says yes.) "Can you wiggle them?"
(She nods affirmatively.) You put on a pair of rubber gloves and examine the patient's knee through her ski pants, noting that there is no swelling, torn clothing, or sign of blood. You palpate the major ligaments around the knee. You: "Does your knee hurt here? How about here? Here?" Patient: "It's a bit tender here." (The patient indicates the inner [medial] part of the joint). You: "Here comes the toboggan. We'll put a splint on your leg to stabilize your knee and make you more comfortable while we give you a ride down to the patrol room."
Related: Splinting a Lower Extremity Injury
Tag: knee
Category: Scenario

Referenced by: Simple Knee Injury

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