# geratric fall



## chri1017 (Sep 6, 2013)

Say you had a 80 year old female who fell from standing onto concrete.  The patient did not hit her head and does not complain of any loc.  Patients is caox3.  Patient does gave a possible Brocken leg.  Who would take spinal precautions?


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## Aidey (Sep 6, 2013)

This sounds like homework.


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## Akulahawk (Sep 6, 2013)

chri1017 said:


> Say you had a 80 year old female who fell from standing onto concrete.  The patient did not hit her head and does not complain of any loc.  Patients is caox3.  Patient does gave a possible Broken leg.  Who would take spinal precautions?


If that's her only likely injuries, I would NOT put her in spinal precautions. Out of curiosity, is her injury a broken hip? If so, might it have been a break and fall? Now why would I not put her in spinal precautions? That is what will lead you to understanding the why (and why not) behind the things we do.


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## Medic Tim (Sep 7, 2013)

chri1017 said:


> Say you had a 80 year old female who fell from standing onto concrete.  The patient did not hit her head and does not complain of any loc.  Patients is caox3.  Patient does gave a possible Brocken leg.  Who would take spinal precautions?



With the info available I probably wouldn't .


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## mycrofft (Sep 7, 2013)

Wait, remember the infamous Brocken's Neck Syndrome!


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## randomfire (Sep 7, 2013)

In my system that would technically be a delta trauma and you would get chewed out if you didn't take her to a trauma center. I'm new so I would probably take precautions just in case. Why shouldn't you though?


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## mycrofft (Sep 7, 2013)

I love when new categories of trauma are devised. The traditional triage ones are effective, yet have their own potholes.
"Delta"?


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## NomadicMedic (Sep 8, 2013)

I assume he's referencing the PMD/Clawson dispatch priorities, ALPHA -> ECHO in response priority. ALPHA is a stubbed toe, DELTA is a "life threatening emergency" and ECHO is reserved for Cardiac and Respiratory Arrests.


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## mycrofft (Sep 8, 2013)

One more protocol to negotiate between systems when something big happens. But I digress, Sorry, OP.


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## randomfire (Sep 8, 2013)

Sorry I assumed most places worked the same way. In my county it's a trauma decision tree where if on your immediate assessment the vitals are bad (GCS<13, sbp<90) it's an alpha trauma. If that's fine, you check for major obvious injuries such as broken long bones, chest wall deformity, amputations proximal to ankle or wrist, any of which make it bravo. Charlie is for MOIs that suggest serious injuries but maybe you don't see any, such as if the vehicle rolled or there was a death in the passenger compartment or a blast injury. Then delta is kind of a catch all if they don't fit in another category, such as even minor traumas involving geriatrics, children, pregnant women > 20 weeks, and people with bleeding disorders.


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## Youngin (Sep 8, 2013)

It'd depend on if she complained of neck and back pain after the fall. Luckily, per my county's protocols, spinal precautions are only required with neck or back pain as a result of a trauma related MOI.


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## mycrofft (Sep 9, 2013)

How about Immediate, Delayed, Minor, Expectant/Expired, the primary c/o in five words or less and the provisional diagnosis in five words or less?


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## adrenalin (Oct 6, 2013)

To me, there doesn't seem to be enough information to cause me to believe that there is a spinal injury.  Did the patient fall sideways, back, forward, etc?  Depending on how she fell would give you a better understanding of what parts of the body have been affected.  Just my thoughts on the scenario though.....


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## NBFFD2433 (Oct 13, 2013)

randomfire said:


> Sorry I assumed most places worked the same way. In my county it's a trauma decision tree where if on your immediate assessment the vitals are bad (GCS<13, sbp<90) it's an alpha trauma. If that's fine, you check for major obvious injuries such as broken long bones, chest wall deformity, amputations proximal to ankle or wrist, any of which make it bravo. Charlie is for MOIs that suggest serious injuries but maybe you don't see any, such as if the vehicle rolled or there was a death in the passenger compartment or a blast injury. Then delta is kind of a catch all if they don't fit in another category, such as even minor traumas involving geriatrics, children, pregnant women > 20 weeks, and people with bleeding disorders.



That's the way it's in my county.


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