Falls are a sentinel event in an older person’s life...
First, start by asking yourself if the patient in front of you would have fallen if he or she was 20 years old? Many patients in our EDs are labelled as having a “mechanical” fall, but there are often modifiable causes of falls that we can, and should, identify...
Take falls, even ones resulting in very minor injury, seriously in the older patient. Ask them about fall history, depression, and medications. Perform orthostatic vitals, and watch them walk as part of your assessment!
Unfortunately, while there are many tools to screen for fall risk, none have been validated in the ED.
While a simple trip-and-fall may not prompt an initial inquiry, multiple falls or first time falls without a clear mechanism should raise a red flag.
As the population ages and people live longer in bad shape, the number of older Americans who fall and suffer serious, even fatal, injuries is soaring.
Geriatric Acute and Post-acute Fall Prevention, a postfall, in-ED, multidisciplinary intervention with pharmacists and physical therapists, reduced 6-month ED encounters in 2 urban EDs. The intervention could provide a model of care to other health care systems aiming to reduce costly and burdensome fall-related events in older adults.
All of us have taken a tumble at some point in our lives. But as we grow older, the risks associated with falling over become greater: we lose physical strength and bone density, our sense of balance deteriorates and we take longer to recover from a fall. Alarmingly, this process begins around the age of 25. The reasons for this are varied and complex, but by understanding them better, we can find ways to mitigate the effects of old age.
The underlying cause is most often incorrect weight shifting, followed by tripping. What’s particularly shocking is that in close to 40 per cent of events, residents sustain impact to their heads.
It’s well known that falls among the elderly are common. Older people are more likely to have impaired vision, dizziness and other de-stabilizing health problems, and are less likely than younger people to have the strength and agility to find their feet once they begin to lose their balance. Elderly people are suffering concussions and other brain injuries from falls at what appear to be unprecedented rates, according to a new report from U.S. government researchers.
Living with the fear of falling also likely increases feelings of anxiety, which could lead a physician to prescribe anti-anxiety medication, such as Xanax. Xanax, along with other benzodiazepines, has been the focus of recent studies that have demonstrated that these types of drugs cause higher risks of falls and dementia.
New research into how we maintain our balance could help athletes and prevent falls among the elderly.
Assess for intrinsic/extrinsic factors for falls and which ones are modifiable: Intrinsic factors: medical illness (Parkinson’s, stroke, diabetes etc.), impaired vision and hearing, age related changes in musculature, gait, and postural reflexes.
Extrinsic factors: medications (sedatives & hypnotics, antihypertensives, diuretics, hypoglycemics), improper/lack of assistive devices for ambulation, environmental hazards (lightning, uneven ground, furniture, household clutter).
If you want to avoid busy A&E units then you should shun the trampoline, discourage the kids from putting Lego up their nose, and be rather more careful getting something out of the loft.
When an elderly person falls, the result can be calamitous: hip fractures are common and serious. But help may be at hand. American researchers have designed a kinder, gentler flooring which is firm enough for people to walk on but buckles if they fall, absorbing the shock of impact.
Tricycle accidents requiring a visit to the emergency room peak when children reach age 2, a new study finds.
What if you could stop accidents before they happened? Researchers at the University of Missouri have developed sensor systems that allow health care professionals to remotely monitor senior citizens around the clock, accurately predicting their chances of falling.
One of the Apple Watch Series 4’s most noteworthy features is one you hope to never use: fall detection. After sensing a person has fallen, the device checks if the person actually fell, if he is OK, and if he needs emergency services. It’s the 21st-century version of Life Alert but built into a popular piece of hardware.
A preoccupation with safety has stripped childhood of independence, risk taking, and discovery—without making it safer. A new kind of playground points to a better solution.
Process and design changes exist that can reduce the risk of falls for emergency department patients. One important process change is identifying patients who are fall risks; checklists at intake can help identify them.
Falls not only are killing more older adults, they are costing the nation billions of dollars. According to one study, the US spent $50 billion in 2015 on falls. Overall, hospital and post-acute costs for traumatic injury (frequently falls) was more than costs for strokes and heart attacks combined.
Falls are the leading cause of injury-related emergency visits in older adults, translating into an estimated 3 million ED visits and 32,000 deaths from fall-related injuries annually in the United States. Falls subsequently result in diminished functional ability and higher risk for future falls and mortality.
It’s important to realize that falls among older persons, with their staggering physical, emotional as well as economic consequences, have the potential to impact not only patients, but all members of a family.
There are many reasons older adults are susceptible to falls. These include side effects of some medications, vision impairments and less ability to prevent tripping over as balance, muscle mass and strength decline with age. The risk of fracture due to poor bones increases with age, and this is further enhanced by osteoporosis.
For history, the following risk factors have been found to be predictive of falls specifically in ED populations: History of falls.
Poor foot care: inability to cut one’s toenails, non-healing foot sores.
Evaluation of older patients with a history of falls is a challenging but crucial component of EM training. We believe our review will be educational for junior and senior EM faculty to better understand these patients' care and to design an evidence-based practice.
Measures frailty to predict survival.
Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again
Crowded, busy emergency departments seem susceptible to an increased risk of slip-and-fall accidents that keep administrators awake at night. But does the evidence bear out this assumption?