54 y/o male .286 blood alcohol. Positive for meth. Stated | Figure 1

54 y/o male .286 blood alcohol. Positive for meth. Stated he was drinking at a friend's and stood up and heard a snap. Obvious deformity on scene. Pedal pulses intact. Continued to try to walk on it. Denied any pain. Immobilized with vacuum split. Iv started and 500 fluid bolus in route to community access hospital. Pain medication not in my scope. Your thoughts on true MOI? Big Er discussion.

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