What are the musculoskeletal causes of falls?
- Arthritis of lower limb joints
- Sarcopenia
- Feet deformities
These factors can lead to weakness or instability, increasing the risk of falls.
Name three neurological causes of falls.
- Stroke
- Parkinsonism
- Dementia
- Delirium (4.5x more likely to fall)
Neurological conditions often impair balance and coordination.
What sensory impairment can contribute to falls?
- Visual impairment
- Inattention
Sensory deficits can lead to decreased awareness of the environment.
List cardiovascular causes of falls.
- Postural hypotension
- Arrhythmia
- Heart failure
- Aortic stenosis
Cardiovascular issues can affect blood flow and stability.
What general health condition can increase the risk of falls?
Being generally unwell and frail
Frailty can lead to decreased strength and balance.
How can incontinence contribute to falls?
Rushing to the toilet
The urgency can lead to hurried movements and potential falls.
What types of drugs are associated with an increased risk of falls?
- Antihypertensives
- Beta blockers
- Sedatives
- Anticholinergics
- Opioids
- Alcohol
These medications can affect balance, cognition, and coordination.
What are common causes of falls in inpatients?
- Postural hypotension
- New medication
- Low blood glucose
- Delirium
- De-conditioning
Inpatients may experience changes that heighten fall risk.
What key questions should be asked during history-taking of falls?
- What were you doing?
- Who were you with?
- What happened?
- How did you get up off the floor?
These questions help identify the context and potential causes of the fall.
What does a clear memory during a fall suggest?
Sensory (Eyes or Nerve) problem
A clear recollection can point towards specific sensory issues.
What are some signs indicating a cardiac problem during a fall?
Palpitations preceding fall
Palpitations may suggest an underlying arrhythmia or heart condition.
What should be assessed in the examination of a fallen patient?
- Cranial nerves
- Check glasses
- Check for neglect
- Cerebellar signs
- Pulse
- Heart sounds
- Blood pressure
A thorough examination is crucial for identifying potential causes of the fall.
What serious injuries should be looked out for in a fallen patient?
- Head injury
- Extradural haemorrhage
- Seizure
- C spine injury
- Flail chest
- Abdominal injury
- Pelvic injury
- Fractures
These injuries can have significant implications for patient care.
When is an immediate CT required after a head injury?
- Low GCS <13
- Confusion after 2 hrs
- Focal neurology
- Signs of skull fracture
- Basal skull fracture (CSF leak, Bruising around eyes)
- Seizure
- Vomiting
- Anti-coagulation
These criteria help identify patients at risk for serious intracranial injuries.
What are some strategies for the prevention of falls?
- Medication review
- Providing walking aids
- Adjusting height of beds
- Ensure vision, mobility aids, and call bells are within reach
Preventive measures can significantly reduce fall risk.
