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Head injury in a cruise passenger during a shore excursion
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Abstract
A 66-year-old overweight insulin-dependent male passenger with diabetes and severe arthritis was on a 4-week circle-Pacific cruise. He fell ashore and hit his head. The ship was about to leave on a non-stop voyage — without any evacuation possibilities for the next 8 days. He was examined and had X-rays taken at the local hospital, but as his head injury was considered mild, he returned to the ship “for 48 hours of observation for signs of intracranial bleeding” — against the ship’s doctor’s advice.
Delayed suspicion of a non-displaced cervical fracture caused extra work and worries and could have, but did not complicate matters.
When there are no life-saving therapy and no timely evacuation possibilities in case of deterioration, on-board observation is counterproductive. The patient should be kept in — or near — the local hospital during the necessary observation period, followed by safe repatriation.
Abstract
A 66-year-old overweight insulin-dependent male passenger with diabetes and severe arthritis was on a 4-week circle-Pacific cruise. He fell ashore and hit his head. The ship was about to leave on a non-stop voyage — without any evacuation possibilities for the next 8 days. He was examined and had X-rays taken at the local hospital, but as his head injury was considered mild, he returned to the ship “for 48 hours of observation for signs of intracranial bleeding” — against the ship’s doctor’s advice.
Delayed suspicion of a non-displaced cervical fracture caused extra work and worries and could have, but did not complicate matters.
When there are no life-saving therapy and no timely evacuation possibilities in case of deterioration, on-board observation is counterproductive. The patient should be kept in — or near — the local hospital during the necessary observation period, followed by safe repatriation.
Keywords
head injury, cervical fracture, on-board observation, maritime medicine
About this articleTitle
Head injury in a cruise passenger during a shore excursion
Journal
Issue
Article type
Case report
Pages
161-162
Published online
2016-09-27
Page views
855
Article views/downloads
899
DOI
10.5603/IMH.2016.0030
Pubmed
Bibliographic record
IMH 2016;67(3):161-162.
Keywords
head injury
cervical fracture
on-board observation
maritime medicine
Authors
Eilif Dahl
