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Prehospital emergency care for patients with suspected hip fractures after falling – older patients' experiences

Authors

  • Kenneth Aronsson MSc, RN PEN,

    1. Emergency Medical Service System at Södra Älvsborg Hospital, Borås, Sweden
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  • Ida Björkdahl MSc, RN PEN,

    1. Emergency Medical Service System at Södra Älvsborg Hospital, Borås, Sweden
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  • Birgitta Wireklint Sundström PhD, RNAN

    Associate Professor, Corresponding author
    1. School of Health Sciences, Research Centre PreHospen, University of Borås, The Prehospital Research Centre of Western Sweden, Borås, Sweden
    • Correspondence: Birgitta Wireklint Sundström, Associate Professor, School of Health Sciences, University of Borås, SE-501 90 Borås, Sweden. Telephone: +46 33 435 47 77.

      E-mail: birgitta.wireklint.sundstrom@hb.se

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Abstract

Aims and objectives

To describe and explain older patients' lived experiences of prehospital emergency care in cases of suspected hip fractures after falling.

Background

Falls among the elderly is an issue internationally and a public health problem that seems to be on the increase. In the emergency medical services, older people are frequent patients after having suffered a fall, but there is little information on how older patients experience prehospital emergency care in cases of suspected hip fractures after falling.

Design

Qualitative interview study.

Methods

Ten older patients were interviewed. These depth interviews were tape-recorded, transcribed verbatim and analysed for meanings.

Results

The comprehensive understanding of the phenomenon is: ‘Glad to have been rescued, despite bad experiences as well as good'. The older patient is offered care in an open and friendly atmosphere concurrently with feeling anxiety about the treatment. Intervention with streamlined care and treatment can thus simultaneously be beneficial as well as doing harm. Patients experience confusion and the need to ask questions about what really happened in the ambulance. Bad experiences remain unexplained. These findings are based on three themes with relevant subthemes: efficiency, concerned encounters and suffering from care.

Conclusions

Our study shows that prehospital emergency care when hip fracture is suspected – from patients' point of view – is insufficient and unsatisfying. Prehospital emergency care for these vulnerable patients could be improved through more compassion being shown towards older patients' existential needs and their increased participation. Furthermore, alternative methods of prehospital pain relief need to be developed.

Relevance to clinical practice

Responsibility for patients' safety regarding pain relief is emphasised. Pain relief in the emergency medical services should be individualised. This development should focus on care that is already good and gradually eradicate compassionless care.

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