A patient arrives at the emergency department with severe lower leg pain after a fall in a touch football game. Following routine triage, which of the following is the appropriate next step in assessment and treatment?
A. Apply heat to the painful area.
B. Apply an elastic bandage to the leg.
C. X-ray the leg.
D. Give pain medication.
Correct Answer: C. X-ray the leg.
Following triage, an x-ray should be performed to rule out fracture. Review follow-up and serial X-rays. Provides visual evidence of proper alignment or beginning callus formation and healing process to determine the level of activity and need for changes in or additional therapy.
Option A: Ice, not heat, should be applied to a recent sports injury. Apply cold or ice pack first 24–72 hr and as necessary. Reduces edema and hematoma formation, decreases pain sensation. Note: Length of application depends on degree of patient comfort and as long as the skin is carefully protected.
Option B: An elastic bandage may be applied. Maintain immobilization of affected part by means of bed rest, cast, splint, traction. Relieves pain and prevents bone displacement and extension of tissue injury. Elevate and support injured extremity. Promotes venous return, decreases edema, and may reduce pain.
Option D: Pain medication can be given once fracture has been excluded. Medicate before care activities. Let the patient know it is important to request medication before pain becomes severe. Promotes muscle relaxation and enhances participation.