Show simple item record

dc.contributor.authorMatthews, Gary
dc.contributor.authorBooth, Helen
dc.contributor.authorWhitley, Gregory
dc.date.accessioned2020-06-26T12:01:38Z
dc.date.available2020-06-26T12:01:38Z
dc.date.issued2020-06-01
dc.identifier.citationMatthews, G., Booth, H. and Whitley, G. A. 2020. Unexpected shock in a fallen older adult: a case report. British Paramedic Journal, 5 (1), 15-19.en_US
dc.identifier.issn1478-4726
dc.identifier.doi10.29045/14784726.2020.06.5.1.15
dc.identifier.urihttp://hdl.handle.net/20.500.12417/825
dc.description.abstractAbstract published with permission. Introduction: Falls are common in older adults and frequently require ambulance service assistance. They are the most frequent cause of injury and associated morbidity and mortality in older adults. In recent years, the typical major trauma patient has changed from being young and male to being older in age, with falls of < 2 metres being the most common mechanism of injury. We present a case of an 84-year-old male who had fallen in his home. This case highlights the complex nature of a relatively common incident. Case presentation: The patient was laid on the floor in the prone position unable to move for 12 hours. He did not complain of any pain in his neck, back, hips or legs, and wished to be lifted off the floor promptly. On examination, he had bruising to his chest and abdomen and had suffered a suspected cervical spine injury due to a step-like protrusion around C5–C6. Distal sensory and motor function was intact. While in the ambulance his blood pressure dropped from 154/119 mmHg to 49/28 mmHg unexpectedly. We successfully reversed the shock using the modified Trendelenburg position and intravenous fluids. On follow-up he was diagnosed with dislocated C3, C6 and C7 vertebrae. Conclusion: The unexpected episode of shock witnessed in this patient may have been caused by a number of phenomena, including but not limited to crush syndrome, spinal cord concussion and orthostatic hypotension. We recommend that clinicians anticipate sudden shock in older adult patients who have fallen and a) have remained static on the floor for an extended period of time or b) are suspected of a spinal injury. We recommend assertive management of these patients to mitigate the impact of shock through postural positioning and consideration of early cannulation.
dc.language.isoenen_US
dc.subjectAccidental Fallsen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectShocken_US
dc.subjectGeriatric Assessmenten_US
dc.subjectAgeden_US
dc.titleUnexpected shock in a fallen older adult: a case reporten_US
dc.typeJournal Article/Review
dc.source.journaltitleBritish Paramedic Journalen_US
dcterms.dateAccepted2020-06-10
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2020-06-10
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2020-06-01
html.description.abstractAbstract published with permission. Introduction: Falls are common in older adults and frequently require ambulance service assistance. They are the most frequent cause of injury and associated morbidity and mortality in older adults. In recent years, the typical major trauma patient has changed from being young and male to being older in age, with falls of < 2 metres being the most common mechanism of injury. We present a case of an 84-year-old male who had fallen in his home. This case highlights the complex nature of a relatively common incident. Case presentation: The patient was laid on the floor in the prone position unable to move for 12 hours. He did not complain of any pain in his neck, back, hips or legs, and wished to be lifted off the floor promptly. On examination, he had bruising to his chest and abdomen and had suffered a suspected cervical spine injury due to a step-like protrusion around C5–C6. Distal sensory and motor function was intact. While in the ambulance his blood pressure dropped from 154/119 mmHg to 49/28 mmHg unexpectedly. We successfully reversed the shock using the modified Trendelenburg position and intravenous fluids. On follow-up he was diagnosed with dislocated C3, C6 and C7 vertebrae. Conclusion: The unexpected episode of shock witnessed in this patient may have been caused by a number of phenomena, including but not limited to crush syndrome, spinal cord concussion and orthostatic hypotension. We recommend that clinicians anticipate sudden shock in older adult patients who have fallen and a) have remained static on the floor for an extended period of time or b) are suspected of a spinal injury. We recommend assertive management of these patients to mitigate the impact of shock through postural positioning and consideration of early cannulation.en_US


This item appears in the following Collection(s)

Show simple item record