Geriatrics - Falls Flashcards
How many elderly people in the community fall every year?
1/3
What are the risk factors for falling?
OLD PERSON
Orthostatic hypotension
Lower limb muscle weakness
Depression
Previous falls
Eye problems
aRthritis and balance
Several medications
Over 65
iNcontinence
Why is incontinence such a big risk factor for falling?
Rushing to toilet and can easily trip
What must you establish in a falls history?
Where, when, who, what, why?
- Where was the patient when they fell?
- When did they fall?
- Who else see the fall?
- What happened, before, during and after?
- Why do they think they fell?
- Have they fallen before?
- Systems review
- PMH
- Social history
Why must a patient’s medication be reviewed in patient’s who fell?
Patients on 4 drugs more likely to fall
What medications cause postural hypotension?
Nitrates
Diuretics
Anticholinergics
Antidepressants
Beta-blockers
L-Dopa
ACEi
What medications are associated with falls other than those that cause postural hypotension?
Benzodiazepines
Antipsychotics
Opioids
Anticonvulsants
Digoxin
Sedatives
What investigations should be done for patient’s that have fallen?
Bedside tests
- Obs
- Blood glucose
- Urine dip
- ECG
Bloods
- FBC
- U&Es
- LFTs
- Bone profile
Imaging
- X-ray of injured limbs
- CT head
- Cardiac echo
What test should be completed for patients with a falls history or at risk of falling?
Turn 180 test
or
Timed up and Go test
When should patients over 65 be offered a multidisciplinary assessment for falling?
- More than 2 falls in last year
- Fall that requires medical treatment
- Poor Turn 180 test or Timed up and Go test
