Falls

Author: Trishan Bali / Editor: Lauren Fraser / Codes:  / Published: 24/08/2020

Falls can be significantly debilitating and distressing events for patients. The elderly form an increasing proportion of the general population, meaning falls are a common presentation to the emergency department (ED); they can also prove to be complex and demand that the doctor play detective in uncovering the details before, during and after the fall of a patient who may, or may not, be able to provide a reliable recount of the events.

This learning session will allow for the exploration and revision of the definition, assessment and management of patients after a falls episode.

Learning objectives: 

• You will be able to define a falling episode
• You will explore the causative factors of a fall
• You will gain greater awareness of the complications of a fall
• You will gain greater confidence in assessing a patient after a fall
• You will be aware of the pitfalls in approaching a patient following a fall

References: 

1. Public Health England. (2020). Falls: applying All Our Health. GOV.UK, [Online]. [Accessed 31 Mar. 2020].
2. National Institute of Health and Care Excellence (NICE). (2013). Falls in older people: assessing risk and prevention. Clinical guideline [CG161]. NICE.
3. Royal College of Emergency Medicine (RCEM). (2019). RCEM National Quality Improvement Project 2019/2020 Assessing for Cognitive Impairment in Older People Information Pack. [Accessed 24 Apr. 2020]
4. OSullivan, D., Brady, N., Manning, E., OShea, E., OGrady, S., O Regan, N., & Timmons, S. (2018). Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees. Age and ageing, 47(1), 61-68.
5. Kannus, P., Niemi, S., Parkkari, J., & Mattila, V. M. (2019). Sharp Rise in Fall-Induced Cervical Spine Injuries Among Older Adults Between 1970 and 2017. The Journals of Gerontology: Series A, glz283.
6. Rockwood, K., Song, X., MacKnight, C., Bergman, H., Hogan, D. B., McDowell, I., & Mitnitski, A. (2005). A global clinical measure of fitness and frailty in elderly people. Cmaj, 173(5), 489-495.
7. NHS Specialised Clinical Frailty Network. (2020). Clinical Frailty Scale.[Accessed 25 Apr. 2020]
8. National Institute of Health and Care Excellence (NICE). (2014). Head injury: assessment and early management. Clinical guideline [CG176]. NICE.
9. Royal College of Emergency Medicine (RCEM). (2018). Fractured Neck of Femur Clinical Audit 2017/18 National Report. [Accessed 31 Mar. 2020]
10. Wongrakpanich, S., Kallis, C., Prasad, P., Rangaswami, J., & Rosenzweig, A. (2018). The Study of Rhabdomyolysis in the Elderly: An Epidemiological Study and Single Center Experience. Aging and Disease, 9(1), pp. 17.
11. Forbes, A., Kundishora, T., & Waiting, J. (2019). Fascia Iliaca Block. RCEMLearning. [Accessed 31 Apr. 2020].