Fall in a Care Home

Scenario

You are the Trauma and Orthopaedic ST3. A 95 year old lady has been under your care. She presented after a fall in her care home she has a bruise on her left forehead. The patient does not take any anticoagulation. She has a history of Dementia and has an AMTS of 3/10. The patient is awaiting a CT head. A X-Ray of her pelvis and right his has been performed, which has revealed a right sided intracapsular displaced neck of femur fracture.

The patients daughter has power of attorney.

  • Introduce yourself
  • Confirm patient’s daughters identity
  • Determine baseline knowledge – ask the patient’s daughter what she knows so far
  • Summaries events surrounding admission
  • Explain that patient’s mother has had an X-Ray of her pelvis and hip to investigate for a broken hip
  • Deliver warning shot and explain that the patient’s hip is broken
  • Explain the next steps in management – CT head, orthogeriatric review and replacement of the femoral head (hemiarthroplasty)
  • Summarise
  • Ask if they have and concerns or questions