Drowsy after a fall

Instructions

You are an intern on the medical ward. It is 3 am. The nurse asks you to see Rocco Battaglia, 79, admitted two days ago with pneumonia. She found him on the floor beside his bed at 1 am; nobody saw him fall. He has become harder to rouse over the last hour.

1. 1

   Assess and manage the patient using an A to E approach

2. 2

   Outline to the examiner:

   • Your most likely diagnosis
   • Next steps in management, including relevant investigations

• A nurse is at the bedside and will carry out your instructions; describe procedures and painful stimuli rather than doing them
• You do not need to take a full history
• You do not need to summarise your findings