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Injury. 2011 Nov;42(11):1257-61. doi: 10.1016/j.injury.2011.01.001. Epub 2011 Feb 19.

Fast-track care for patients with suspected hip fracture.

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Division of Paramedical Transports, Halland County Council, Sweden.


Patients over 65 years of age with suspected hip fracture following low-energy trauma often wait a long time for examinations, X-rays, tests and surgery. There may be a connection between long waiting times and complications, including severe pain, mental confusion, infection, pressure sores, and longer hospital stays. This study examines whether implementing prehospital preoperative procedures might lead to reduced waiting times, less postoperative pain, fewer complications and shorter length of care for this patient group. To "fast-track" care for hip fracture patients, the ambulance nurse starts the preoperative procedure (usually performed in the accident and emergency department [A&E]) and transfers patients directly to radiology, bypassing A&E. Results from the fast-track care group were compared to results from a control group, who had been admitted to A&E in the usual way. The study group experienced fewer complications and shorter hospital stays compared to the control group. This finding suggests that fast-track care for hip fracture patients can minimise complications, heighten priorities, and decrease overall length of care. Greater awareness of risk factors for hip fracture patients amongst hospital staff leads to improved patient care. Fast-track care may also decrease the workload in A&E and thus release more time for other patients.

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