Vol 67, No 3 (2016)
Case report
Published online: 2016-09-27

open access

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Head injury in a cruise passenger during a shore excursion

Eilif Dahl
Pubmed: 27681216
IMH 2016;67(3):161-162.


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.

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