Author: Ruth Creamer / Editor: Yasmin Sultan, Ahmad Alabood / Codes: / Published: 27/09/2023
An 85-year-old lady is brought in by ambulance after an unwitnessed fall from standing in a nursing home. She is on oral antibiotics for a UTI. She has a visibly deformed right wrist and extensive visible bruising over the left side of her forehead and left cheek. She has vomited twice.
The patient cannot tell you how she fell. She is fully cooperative but slightly confused, scoring two on the AMT 4 test. She does not have a letter from the nursing home.
Examination reveals no focal neurological deficit. She has normal eye movements. On examination of her cervical spine she has mild bony tenderness over C3-5 but demonstrates full range of movement in her neck.
The paramedics report that she had mild neck pain and swollen wrists with dorsal angulation on her right wrist. The observations and ECG are unremarkable, and A right wrist X-ray has been requested at triage.
