A patient with an ankle sprain exhibits worsening swelling. What is the best intervention at this time?

The most effective intervention for a patient with an ankle sprain that is exhibiting worsening swelling involves using a combination of cold therapy and intermittent compression, along with elevation of the limb. This approach is beneficial for several reasons.

Cold therapy is instrumental in reducing inflammation and pain immediately following an injury. The cold works to constrict blood vessels, which minimizes blood flow to the affected area, thus attending to the acute phase of swelling.

Intermittent compression provides mechanical support that helps prevent the accumulation of excess fluid in the tissues, further controlling swelling. By applying pressure to the swollen area and using a rhythmic release, intermittent compression can effectively assist in promoting circulation and lymphatic drainage.

Elevating the limb is critical as it utilizes gravity to decrease hydrostatic pressure in the venous system, facilitating venous return and reducing swelling.

Combining these strategies—cold for pain and inflammation reduction, intermittent compression for mechanical support and fluid control, and elevation for enhanced venous drainage—addresses the swelling holistically and is particularly suited for an acute injury like an ankle sprain. This multifaceted approach is especially advantageous when a patient presents with worsening symptoms, indicating a need for comprehensive intervention to manage and mitigate swelling effectively.