Just wondering what to expect here. So, 2 weeks into internship and I get a patient in the E.R. s/p fall, struck head on ground, questionable L.O.C., possible altered mental status (we didn't know his baseline). Hx of multiple CVAs (hemiparesis) and ESRD (had dialysis that morning). BP was 90/60 in triage and about the same when I saw him. He said that his BP is always low following dialysis. Exam was essentially unremarkable with the exception of some right thigh pain, presumably resulting from the fall, with slight anterior/posterior pressure. I present the patient to the attending who subsequently sees him. While we're in there, his nephrologist (who originally sent the patient to the E.R. following the fall), comes in and wants to admit him and recommends us giving him a liter NSS bolus, which we do. Patient's BP remains at 90/60 as he's getting the bolus, seems stable enough and the attending is still in there, and I go on to see the next patient. Not 10 minutes later, there's a trauma alert and they're wheeling my guy into the trauma bay. As it turns out, his BP dropped to 70/40 when I was with the other patient as a result of an acetabular fracture. He dies in the ICU later that night. No, this isn't how I was expecting my intern year to start out. Myself and the attendings were fixated on this guy's possible head injury and assumed his LBP was secondary to dialysis. Anyway, the case is being presented at this week's M&M and I really don't know what to expect. Any advice is very appreciated. Thanks.