A 79-year-old nursing home resident was brought in by ambulance to her local A&E after being found on the floor in her bedroom following an “unwitnessed fall.” The accident had occurred within the preceding hour, as she had received her morning medication without concern. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. %%EOF h�b```f``M``c`�8� Ȁ �,�@�1���S�����M�s q�. If you do not agree to our terms of use and Privacy Notice, please do not use this website or provide any rating, review feedback. Several days later, when cognition had improved, she was noted to be avoiding use of the left arm and was found to also have a left proximal humerus fracture which was managed conservatively. 0000038271 00000 n Spaniolas et al. 34 44 Introduction. 1 North Central Thames Foundation School, UCL Medical School, Royal Free Hospital, Room GF/664, Rowland Hill Street, London NW3 2PF, UK. Other independent associations with PAN-SCAN diagnostic imaging are reduced ITU stay and overall hospital length of stay, the obvious implication being that this would offset the higher initial costs of the investigation. Although no history about the fall was obtainable in this case, the authors suspect that it may have in fact been related to a seizure, rather than a simple fall, given the further seizures in hospital, the severity of injury, and the nature of having a posterior fracture dislocation of the right shoulder, which is more commonly seen following seizure activity. 2 Trauma & Orthopaedics, Barnet Hospital, Wellhouse Lane, Barnet, Hertfordshire EN5 3DJ, UK. 5 5 0. The combination of a greater likelihood of extensive medical comorbidities and a difficult, less-thorough assessment means that elderly trauma victims have significantly worse outcomes compared to their younger counterparts [4]. Velmahos et al. The inability of these populations to communicate pain and discomfort is a major barrier to adequate assessment and diagnosis, and, therefore, this alone should mandate a full trauma assessment to avoid missing injuries, which account for a significant healthcare burden [10]. These severe injuries corroborate with the current change in attitude towards low impact trauma, with several studies demonstrating the significant morbidity and mortality associated with such cases [1, 2, 4]. Ground level falls in geriatric patients are a common presentation and represent a significant proportion of hospitalised trauma cases, a trend which is set to continue in the presence of an ever aging population [1].
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