Table 1 Case vignettes
From: Provision of acute care pathways for older major trauma patients in the UK
Four cases representing a variety of trauma presentations in older patients. | |
|---|---|
Case 1 | 83-year-old female presenting after a fall. Full trauma CT identifies the only injury as a minor frontal cerebral contusion. No other injuries. Mildly confused but no focal neurological deficit. Patient requires 24 hrs neurological observations but no neurosurgical intervention. |
Case 2 | 68-year-old male presenting after fall 3 m from a ladder. Full trauma CT identifies isolated chest trauma (left 8th and 9th rib fractures but no pneumo-haemothorax). On apixaban for atrial fibrillation. No other injuries. He is in moderate pain after 5 mg morphine. |
Case 3 | 91-year-old female mechanical fall getting out of the shower. Has dementia. Has home care four times a day. CT head and neck reveals a 3rd cervical vertebral fracture. Neurosurgical team advise conservative management with Miami J collar |
Case 4 | 72-year-old male fall 14 steps. Initially had acute right sided subdural haemorrhage requiring craniotomy and evacuation of haematoma. Slow improvement on ICU and remains with a tracheostomy and nasogastric tube. Awaiting a percutaneous endoscopic gastrostomy and having tracheostomy weaning. He is ready for stepdown from intensive care unit / ready for repatriation to his local trauma unit. |