Head injury in a cruise passenger during a shore excursion.
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.
Department of Occupational Health, Haukeland University Hospital, the Norwegian Centre for Maritime Medicine, Bergen, Norway. eilifdahl@hotmail.com.
Eilif
E
Dahl
D000368:Aged; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000175:diagnosis*; D008297:Male; D009326:Naval Medicine; D019370:Observation; D016103:Spinal Fractures / Q000175:diagnosis
cervical fracture; head injury; maritime medicine; on-board observation