12. Red flags and emergency escalation
Any of the following is acted on immediately. EMS is activated first for life- or limb-threatening findings; provider and therapy notification and orders follow.
Red flags — act immediately Suspected hip fracture after a fall — the leg is shortened, externally rotated, and painful, with inability to bear weight → do not mobilize; immobilize, manage pain, and activate EMS. Pain out of proportion with pallor, paresthesia, pulselessness, or a tense, tight compartment → compartment syndrome — activate EMS; this is a limb emergency. New back pain with new bowel or bladder dysfunction or saddle anesthesia → cauda equina syndrome — activate EMS. Acute hot, swollen, red joint with fever → septic arthritis; notify for urgent evaluation — a joint-destroying emergency. Post-operative hip with sudden pain, shortening or rotation of the leg, or a “pop” → possible dislocation; do not force motion, notify urgently. A new fall with a head strike, especially on an anticoagulant → manage per the head-injury pathway and activate EMS (cross-reference Head/Scalp and Anticoagulation). |
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