An apparently intoxicated 23-year-old woman attempted to tackle her boyfriend by jumping from the handrail outside her second-st
ory apartment. The boyfriend dodged her tackle and was not injured. The woman has severe pain in both feet and an obvious deformity in her lower left leg at the ankle. Witnesses tell your partner that she landed flat-footed. During a secondary survey, you discover that the capillary refill time in the toes of her left foot is nearly 4 seconds. You should: A) place her in a pneumatic antishock garment (PASG) to help immobilize the ankle. B) apply gentle traction to the bone injury and splint the ankle with a padded rigid splint. C) apply a pillow splint around her ankle. D) lower her foot from the stretcher to improve blood flow.
Answer: B) apply gentle traction to the bone injury and splint the ankle with a padded rigid splint.
Explanation:
Capillary refill time is the time taken by the capillary bed to change color from red to complete blanching. It can be measured by holding the hand to a level higher than the heart level and by applying pressure over the soft pad of fingers and observing the color change. Normal capillary refill time is 2 seconds.
A capillary time of 4 seconds indicates that capillaries are not functioning properly and blood is not reached immediately over the feet. Thus application of traction can help by pulling the fractured body part. The split is a medical device which can provide support to the ankle.
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