It’s a warm and sunny day. The resort is busy: it’s spring break time.
You receive a call for a fallen skier in the advanced terrain park. Upon arrival, you find an adult male lying on his left side in the flats beyond the landing of a large table top. Recognizing the risk of working in this area, you call to a nearby park crew member and ask them to close the jump line. They move to the lip of the jump and direct riders away from the feature. You move to assess your patient.
He is wearing jeans and a sweatshirt, and rental ski equipment is scattered around him. When you ask him what happened, he says that after having fun in the beginner terrain park, he thought he’d try a bigger jump. He thinks that he went too fast, because he landed on the flat snow past the jump and hasn’t been able to move since. He appears to be very uncomfortable, but he’s speaking to you clearly and seems focused on pain in his left leg.
You kneel beside the patient and begin a conversation to assess his mental status while performing a primary trauma survey. He is speaking clearly and breathing normally. His radial pulse is strong, and he is maintaining normal skin color. You check for any other signs of injury and gently palpate along his cervical spine while asking about neck pain. He denies head or neck pain. You ask him to keep his neck still for the remainder of the exam. His upper extremities move normally, and he denies any tingling, numbness, or weakness in his arms or right leg. There is no gross instability of the pelvis, though he winces when you apply gentle pressure over the lateral left hip.
His left leg appears slightly shortened and externally rotated. He has tenderness over the inguinal crease and lateral hip but no deformity of the upper leg. He denies numbness or tingling in his left foot but reports significant pain with any attempt to move his left knee or leg. He says that he can wiggle his toes in his ski boot.
You call to dispatch with your report: “I’m here with Tom, a 45 year old male with a fall to flat in the terrain park. I’m concerned about a possible hip fracture. I’d like a toboggan with a backboard or vacuum mattress, as well as the trauma pack, and a pelvic binder. Vital signs are as follows…”
Additional patrollers and resources arrive on scene and you shift your attention to packaging the patient.
The patient is carefully packaged into the toboggan, and once secured is significantly more comfortable.