Elderly-Immobility and Frailty Flashcards
what are the basic rules for old people and falls
there is more than one thing likely to be wrong
one presenting complaint can lead to many diagnoses
falls in falls clinics
likely to be well
difficult and multifactorial falls
falls in a and e
more likely to be acutely unwell tired injured in pain unable to stand systemically unwell cognitive impairment incontinence syncope check for delirium
assessing a hospital inpatient who has fallen
very likely to be acutely unwell
who is int he MDT for falls
nurse-eye tests BP
physiotherapist -full assessment of gait and balance
doctor-history and examination
what should you include in a history about a fall
detail of fall-who were you with what were you doing, what happened next no memory? palpitation on turning or standing up syncope on exerction-aortic stenosis
what to include in systemic enquiry
memory
urinary symptoms
change in walking
what to include in the exmaination
head and arms cranial nerves cerebellar signs pulse heart sounds
what to examine in the legs
look at feet
check sensation, vibration, proprioception
assess gait
what are ask causes of falls
arthritis in weight bearing joints deformities of feet
what are drug causes of falls
antihypertensives alcohol decrease BP decrease awareness they increases dizziness and hallucintation
what are neurological causes of falls
stroke
dementia
delirium
what are sensory causes of falls
visual Impaiemnt
hearing
what are cardio causes
postural hypotension
HF
aortic stenosis
what are the culprit drugs
alcohol
antihypertensives
sedatives
opioids
