Chronic illness masquerading as acute injury in pre-hospital care.

Clinical diagnosis in pre-hospital care is challenging. It aims to identify life-threatening pathology that requires immediate treatment prior to evacuation to hospital. This case report present two elderly patients injured in a road traffic accident who presented with signs consistent with acute life-threatening pathology. Subsequent investigations in hospital revealed that in both patients, the underlying pathology was secondary to chronic malignancy and not as a result of any injury sustained during the accident. The importance of past medical history and the incidence of co-morbidity in relation to pre-hospital care are discussed.