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An 85-year-old woman is admitted to the hospital through the emergency department (ED) after she tripped and fell at home. On arrival in the ED, she reported that she hit her head against the bedroom nightstand but did not lose consciousness. The patient is a widow who lives alone at home and was found on the floor by her neighbor who checks in on her every day. She has one daughter who lives 50 miles away. The patient had previously been active and independent and able to perform activities of daily living and walk around her neighborhood. She has type 2 diabetes mellitus treated with glyburide (5 mg daily) and nonvalvular atrial fibrillation treated with apixaban (5 mg twice daily). On examination in the ED, the patient appears thin and frail. She reports severe spasms and pain in her right hip. There is shortening and external rotation of the right lower extremity.
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• Arvind Nana, MD
• Tom Robinson, MD
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