Limb Trauma Scenario

As the patient has an isolated traumatic knee injury, a CABCDE primary assessment would be inappropriate for this patient?

You quickly complete your ABCDE assessment and find no other concerns. As your colleague starts to look at the patient’s knee, you complete initial observations of: HR 105, RR 24, BP 138/82, SpO₂ 100%, Temp 36.0, BM 5.1. What is the patient’s NEWS?

What is the likely reason for the patient’s increased NEWS score?

You are not concerned there are any other issues with the patient. They are usually fit and well, have no past medical history, do not take any regular medication, and have no red flags in the history you have taken so far. What presentation would you expect when looking at a simple patella dislocation?

According to several reviews, which soft tissue structure is most commonly injured during a lateral patella dislocation?

If the patient experiences medial pain, does this commonly suggest damage to the patellofemoral ligament?

The patient presents with a simple, lateral patella dislocation. You suggest to your colleague that you both relocate it before trying to move the patient. What statement best suits the advice JRCALC recommend on dislocations and relocations?

When assessing an acutely injured limb, any neurovascular compromise should be determined before and after any reduction or relocation. What features may present if your patient had neurovascular compromise distal to the injury?

The patient is showing no signs of neurovascular compromise. What stepwise pain relief would be more appropriate to administer before performing relocation of this injury?

You prepare Penthrox, as once relocated, it should significantly reduce the pain, so you only require short-term pain relief. What best describes the procedure for relocating a patella dislocation?

You guide the patella back into place as your colleague straightens the leg. The patient expresses relief as the patella relocates and his pain significantly reduces. How should you further manage this patient?

Does this patient require hospital transport and review even though the injury has been relocated?

Which strategy would be most appropriate to immobilise the leg if transporting the patient? 

What potential complication is more likely to occur following a patient’s first patella dislocation?

Compartment syndrome should be assessed for in every acutely injured limb, as it may require urgent transfer to the nearest appropriate hospital?