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(Solved): You are dispatched to the local high school on a report of a fall. Upon arrival at the school, you r ...



You are dispatched to the local high school on a report of a fall. Upon arrival at the school, you report to the office, where you find that your patient slipped on a wet floor and “twisted his ankle.” Your 50-year-old patient is Mr. Johnson, the school principal. He says, “I’m sorry you were sent out for nothing. I’m more embarrassed than hurt.” You introduce yourself and ask if you can check him over anyway, so long as you’re here. He agrees. On your primary assessment, you find him alert and oriented, having no apparent difficulty breathing and in no apparent distress. You see no signs of bleeding. Mr. Johnson lets your partner check his pulse, which is strong and regular. His skin is pink, warm, and dry. During your focused physical exam, Mr. Johnson’s right ankle, which he reports is “a little sore,” is markedly swollen, discolored, and very tender to gentle palpation. His foot is slightly pale but warm to the touch. His pedal pulse is present, and he has good sensation and motion. Vital signs: blood pressure 138/78 mmHg, pulse 68 beats per minute, and respirations 18 per minute and adequate; PaO2 is 96% on room air. The skin and pupils are still normal. You complete your history and find that Mr. Johnson has no allergies and takes no medications. He denies any medical problems, loss of consciousness, or any other injuries. He had soup and a sandwich for lunch about a half hour ago. He says he has felt fine all day but slipped on some water on the floor as he left the cafeteria. You urge Mr. Johnson to allow you to splint his ankle and transport him to the hospital so he can get X-rays to see if his ankle is broken. He refuses, saying, “Thanks for checking me out, but you guys have to be available for real emergencies. I’ve already called my wife, and she’s on her way to take me to the doctor. She ought to be here in 10 minutes or so. Bad enough that I fell down in front of half the school. There’s no way I’m going out of here on that stretcher.” You agree that he’s stable enough to be transported by car, but remind him that he shouldn’t bear any weight on his ankle until he’s been seen by the doctor. You also remind him that if any problems arise or if he changes his mind, he should call 911 Before leaving thr scene what should yiu do?



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