Responses to the local retirement community aren't unusual for Attack One. This morning's call is for a "woman down," but the location is somewhere between the different areas of the community. A concerned staff member finally guides the crew to the side of an elderly lady lying awkwardly in a hallway, with an obvious fracture of her right hip. It's easy to see what happened: A patch of ice formed in the unheated walkway between the buildings, leading to a slip and fall. The lady says it happened around 0700 hours, and gives a very lucid history of taking her morning walk between her apartment and the assisted-care portion of the complex.

   It's cold in the hallway, so the crew quickly moves the woman onto a long backboard and wrap her in a blanket. She has suffered a ground-level fall, has no signs or symptoms of a head or neck injury, and has been moving her neck actively, so they complete their cervical spine clearance per protocol. She complains only of right hip pain, and wiggles her toes actively. The cold conditions and the fact that the patient has been lying in the hall for almost two hours suggest that everyone quickly make their way to the warmth of the ambulance. The paramedic asks facility staff for any medical records but is told there are none, because the patient lives in the "independent living" area of the complex. She will have to give her own history and provide a list of her own medications.

   As the stretcher is loaded into the ambulance, the patient says she's uncomfortable on the long backboard and asks to move to a more comfortable position. The crew members agree—they just needed to get her off that cold floor quickly and into the warm ambulance. They warm the patient compartment, then unwrap the patient, checking completely for injuries. The woman's right leg is shortened and externally rotated, typical of a broken hip. She indicates that it feels best if she leaves it in that position, and the crew pads her lower back and stacks a pillow and towels to keep her leg in the position she prefers. They find no other injuries.

   As crew members make her comfortable, they try to get the rest of her medical history and find out what medications she's taking. The patient is vague—she knows she has a heart problem of some kind, and has had pneumonia. She denies any prior bone injuries. She cannot remember the names of any of her medications. She denies having medicine allergies.