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Clinical scenario: 25-year-old female with possible fracture

You are asked to respond to a residence for a report of a broken arm

“Squad 7, respond priority 3 for a 25-year-old female. Caller states that she fell down and thinks she may have broken her wrist.”

You are met at the front door of the residence by a male. He identifies himself as the patient’s husband and motions to the kitchen. “She’s in there,” he says. “It’s so like her to fall and get hurt, she’s very clumsy.”

You walk into the kitchen and see your patient seated at the table supporting her right wrist. Two young children are sitting at the table as well. You introduce yourself and ask what happened. Her husband, standing behind you, says “She fell down the stairs.”

Meredith, the patient, glances over your shoulder at her husband and replies softly, “I tripped down the steps walking into the garage and fell forward.”

“I told her not to call you guys,” her husband says. “But she wouldn’t listen.”

As you begin to assess her arm you note obvious deformity and swelling to Meredith’s wrist. She winces with any palpation or movement. As you visualize Meredith’s arm you make note of several large bruises of varying age on her upper and lower arm.

Think about these questions as you consider what to do next:

  • What are some potential concerns about the scene you are on?
  • What are some ways to deescalate a situation that could suddenly become violent?
  • What are your reporting obligations on a call like this?

Post your answers below in the comments and view the clinical solution for this patient.

An EMS practitioner for nearly 15 years, Patrick Lickiss is currently located in Grand Rapids, MI. He is interested in education and research and hopes to further the expansion of evidence-based practice in EMS. He is also an avid homebrewer and runner.