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Scenario: A Tackled Knee


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
The first aiders are called to a patient who has injured their leg playing rugby. In the tackle, the patient's lower leg moved over 90 degrees in the wrong direction around the knee and they are now in a lot of pain. The patient's team mates have called the first aiders over. This scenario is a test of dealing with a sporting related trauma and gets them to investigate the injury fully to ensure they don't miss circulation and sensation abnormalities beyond the point of the injury.
Difficulty:
First Aider Easy
How the scenario should progress:
The patient will not deteriorate during the scenario but the first aiders will find (if they check) that the patient does not have a pulse in their leg and does not have sensation on the top of the foot.
Patient 1:
Name: Edna Cruz    Age: 19    Sex: Female
Medication: None Known
Allergies: None Known
Past medical/family/social history: Usually fit and well. Never been to hospital before.
Findings on examination: The patient's lower leg freely moves in pretty much all directions around the knee. The patient is in huge amounts of pain (rated 9/10 which gets to 10/10 when moved) and is a sharp throbbing pain. The pain radiates slightly up the leg but this is dwarfed by the pain in her knee. Skin colour below the knee is slightly paler than the same area on the other leg. No pulse will be found in her foot and she is unable to move it up and down. There is also a loss of sensation on the top part of the foot. She has no other injuries and did not significantly hit her head in the tackle. Patient has no pain other than in her leg. The pain came on immediately and is least when keeping still. Patient observations will stay fairly similar throughout.
Possible treatment from first aiders: Immobilisation of the limb, pain relief, 999 transport to hospital.
Time after start: 0 mins 5 mins
Response: Alert Alert
Airway: Yes Yes
Breathing? Yes Yes
Respirations: 22 20
Pulse: 135 130
Oxygen Sats: 95 on air 94



Tips for the patient actors:
Try to act the pain consistently throughout the scenario and stay in character. You are quite scared as well as you've never been to hospital or injured yourself like this before.

Scenario submitted by: Scenario Library