asked 3 years ago
Teenage patient who dislocated his knee on trampoline while play fighting(fit conditions, no contraindications). Assessment showed obvious deformity to his knee, but the patellar may have "rolled", looks pointy, and appears to be perpendicular to the anterior side. We did not attempt to put it back due to the presentation of the injury, just administered analgesia, and transported. Partner and I wanted to stay in the ER a bit and see what the physician would do, but it was quite busy shift and we didn't have a chance to. I am wondering what are some other things we could have done.
1 Answers
answered 3 years ago
Very good question. Sometimes when we have a new directive, there is an eagerness to use it whenever possible. In this case, the patient’s presentation was not as expected and so in keeping with the number one mantra in medicine - first, do no harm - you chose wisely not to attempt reduction. More than likely this case will have involved imaging to assess the position of the patella and procedural sedation if it was reducible. All you can do is to stabilize the leg, provide analgesia and then timely transport. It may not sound like enough, but sometimes, less is more. Good work.
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