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BOAST Guidance
- #NoF patients (or other fragility fracture) who requiring CT Head (for head injury) also be performed a CT Neck
- Fragility fractures indicate the patient is at high risk of also sustain C-Spine injury.
- Also the pain is likely distracting and the patient is often over 65yrs old so Canadian C-Spine rules will not apply.
Hx/Exam
- Why did They Fall? – was this a collapse?
- Are they sick? – Co-morbidity/illness is common in this group and must be recognised
- Anticoagulants? – This affects treatment
- On Warfarin – If INR >1.5 (or unavailable) Vit-K 5mg
- Other injuries? – >65’s the most common mechanism of TARN major trauma is fall <2m
- Typically – Pain hip/buttock, shortened, externally rotated
- Atypical – Few signs (can they lift their leg & is rotation at the hip painful)