Home
Pneumonia Pathway
Within 15 minutes of arrival:
Patient arrives in A & E
Triage Nurse Fast Tracks Patient if:
- History of Fall
- Unable to top weight bear
- Limb shortened/Externally rotated
Inpatient on Ward
Fast Track Patient if:
- History of Fall
- Unable to top weight bear
- Limb shortened/Externally rotated
Within 1 hour of arrival:
Suspicion of #NOF?
Yes
Validated pain score
assessment completed 
Insert IV Cannula
Medications:
- Titrate IV Morphine Analgesia
+ Cyclizine anti-emetic
Investigations:
- FBC, U&E, G&C, Clotting (if on anticoagulants)
- X-Ray Neck of Femur AP and Lateral
No
No Fracture - Consider other diagnosis
Fracture confirmed on X-ray?
Yes
Investigations:
- Chest X-Ray
No
No Fracture - Consider other diagnosis
IV Fluids (Maintain NBM until Ortho Review)
Contact Trauma Co-ordinator on BLP 599 (M-F, 9-5) OR if Out of Hours Bleep 920 to inform Orthopaedics of potential patient and prepare bed
Within 4 hours of arrival:
Does patient have any of the following life threatening conditions?
- Pneumonia
- Acute MI
- Severe Sepsis
- Acute Stroke
- DKA on Admission
- Head Injury
- Acute deterioration of GCS
- Chest Injury/Fractured Rib
(Refer to HDU with joint care from Orthopaedics
and Cardiothoracic)
Yes
Discuss with Medics
- Consider medical
admission
Admit to AMU or Acute Ward
Patient assessed at
Post Take Ward Round
Daily input from
Orthogeriatrician. Repeat if not suitable for surgery.
No
If no Medical Cause for Fail.
Specialist commences ICP paper document in A&E.