Male aged 38 comes in by ambulance at 4am. He has a painful left thigh.
He is an alcoholic, and went shopping about 3 days ago to get food and
drink. He thinks he banged his leg during the trip, and it is still
sore. He has come into the ED as the painkillers his GP prescribed 2
days ago haven't helped.
The ambulance sheet is rich with exclamation marks for calling them at
this hour. Their observations are pulse 75bpm, systolic >89mmHg, sats on
air 98% and coma scale 15.
He has no other medical history of consequence. He has no recent history
of travel and has no respiratory symptoms.
Review in the department shows a man with stable vitals; pulse 74bpm,
temp 35 degC and walking with a little difficulty. General examination
is unremarkable; clear chest, normal heart sounds. His leg is tender to
touch on the medial aspect of the thigh and reddened; it feels
locally hard to the touch. The leg is intact neurovascularly.
How would you manage this patient?
/Rowley./
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