Question

A 40-year-old patient has been admitted to the critical care unit after sustaining multiple injuries from a cave-in accident this morning. X-ray films confirm multiple fractures, including the left femur. During the afternoon, he was taken to surgery for internal fixation of the left femur. It is now 10 pm, and the patient is complaining of severe throbbing pain in his thigh. The patient received 5 mg of morphine sulfate IV 30 min ago. The anterior left thigh is firm to touch, and the pain increases when the patient flexes his left leg. Further assessment reveals that swelling extends to the knee, and popliteal, posterior tibial, and dorsalis pedis pulses are not palpable. What should be done next?

A. Call the physician and prepare for fasciotomy.
B. Check pulses with a Doppler stethoscope.
C. Call the physician and prepare for embolectomy.
D. Check for Homans sign.

Answer 1

In this scenario, a patient with a left femur fracture is experiencing severe pain and non-palpable pulses. These symptoms indicate compartment syndrome, and the next step should be to call the physician and prepare for fasciotomy.

Step-by-step explanation:

In this scenario, the patient with a left femur fracture is presenting with severe pain, a firm thigh, and non-palpable pulses. These symptoms are consistent with compartment syndrome, which is a surgical emergency. Therefore, the next step should be to call the physician and prepare for fasciotomy.