Clinical Case Database / Category: Clinical Care

Management of the older patient attending hospital with a fall

Publication details

James D. Crane, Dr. Finbarr C. Martin
Foundation Years Journal, volume 2, issue 6, p.260 (123Doc Education, London, July 2008)


Mrs. Turner is an 82-year-old woman who has been brought in by ambulance to the Emergency Department of her local district general hospital, accompanied by her daughter. Her daughter called by in the morning as planned and, having let herself in when there was no answer to the doorbell, found her lying on the landing outside her bedroom. The ambulance crew report that she had been incontinent of urine. Her GCS was noted to be 15/15. She complained of pain in the upper thigh but denied any head or neck injury. On arrival in the MAU she had her baseline observations recorded by nursing staff: she is alert, her pulse is 55 bpm, BP 140/85, respiratory rate 16, oxygen saturation 99%, temperature 37.8°C. A urine dipstick shows leukocytes , ketones but is otherwise clear. X-rays ordered by the Emergency Department staff showed a left pubic ramus fracture, but the hips were OK. Analgesia was given promptly

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James D. Crane

Horton General Hospital, Banbury
Part of Oxford Radcliffe Hospitals NHS Trust
Headley Way

Dr. Finbarr C. Martin (Corresponding author)

Consultant Physician
Guys and St Thomas’ NHS Foundation Trust
Westminster Bridge Road


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