You are the FACEM in charge working in an urban district mixed emergency department. An 8-year-old boy is brought in by his teacher after falling on his outstretched hand from the monkey bars at school. This is his X-ray ordered at triage.

Paediatric distal radius fracture

1. Describe and interpret this left lateral wrist X-ray. 2 marks

2. List (4) acute complications of this injury. 4 marks

3. The child is in severe pain. List options for initial management. 6 marks

You decide to proceed with reduction in the ED under ketamine procedural sedation.

4. List (6) potential side effects of ketamine sedation. 6 marks