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Scenario: Arm Wrestling Risk


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's home who has hurt her arm whilst arm wrestling her boyfriend. On arrival the patient is alert and sitting on an armchair with her arm hanging down keeping it still. The humerus can be seen to be obviously deformed from the doorway. This scenario tests fracture management skills.
Difficulty:
First Aider Easy
How the scenario should progress:
The patient will be stable throughout.
Patient 1:
Name: Lillian Jennings    Age: 19    Sex: Female
Medication: Has taken a 'load of MDMA' not long before arm wrestling.
Allergies: None Known
Past medical/family/social history: Usually fit and well.
Findings on examination: Upper arm evidently deformed. Swelling is present. Is a closed fracture. Patient says she heard a loud snap when it happened. It hurts 'quite a bit' although when keeping still it is rated about 5/10. When moved this goes up to 9/10. The pain is described as stabbing and sharp and shoots up and down the arm from time to time. Patient is in fairly good spirits despite the broken arm. Skin colour is normal. Patient's breathing is normal. Patient able to move hand distal to injury although it hurts. There is circulation and sensation distal to injury.
Possible treatment from first aiders: Immobilisation if possible. Request ambulance back-up if not on an ambulance. Pain relief.
Time after start: Similar throughout
Response: Alert
Airway: Yes
Breathing? Yes
Respirations: 19
Pulse: 140 strong
Oxygen Sats: 94%
Blood Pressure: 135/90
Temperature: 37.1
Blood Glucose: 4.3



Tips for the patient actors:
You are fairly jolly as a result of the drugs you have taken although do get a bit more upset when the arm is moved.

Scenario submitted by: Anonymous