Case study 1: Imperial College Healthcare NHS Trust (Learning Disability / A&E)
A 40 year old woman was brought into a London emergency department by ambulance following an episode of prolonged fitting. Her arrival caused disruption, as she was very combative in the department, both with the ambulance personnel and with the emergency staff. She presented as incoherent, uncoordinated and very unstable on her feet. Despite this physical vulnerability, she refused to sit on a trolley or on a chair and backed herself into a corner of the resuscitation room.
On presentation, the clinical team’s judgement was that she had no serious injury or illness that put her in immediate physical danger.