On examination, Fiona was depressed but responsive. Temperature was 100.4ºF (38C), heart rate was 130 bpm, and respiratory rate was 36 breaths/min. BCS was 5 of 9. Pain assessment with the short form of the Glasgow Composite Measure Pain Scale1 revealed a score of 8 of 24; scores greater than 6 of 24 indicate that interventional analgesia should be provided.1 Physical examination showed hematoma and marked edema in the region of the distal left femur. A fracture was noted on palpation. No other abnormalities were noted.