Case 4

A 25-year-old male has presented to the ED having performed a charity parachute jump. He landed awkwardly and has sustained an open fracture dislocation of his right ankle. He is still wearing sturdy leather boots.

He has no medical problems or allergies but had two bacon rolls and a cup of coffee while waiting for his flight to take off, 90 minutes ago.

He has a cool foot with a capillary refill time of 6 seconds and diminished gross sensation.