End of Life Ethics Flashcards
What are some causes of falls?
Arthritis, deformities of foot, anti-hypertensives, sedatives, stroke, dementia, visual impairment, postural hypertension, arrhythmia and rushing to the toilet
How does drugs cause falls?
Decreases BP, HR and awareness
Increases urine output, sedation, hallucination, qTC and dizziness
What are the drugs which can cause falls?
Anti-hypertensives, beta-blocker, sedatives, anticholinergics, opioids and alcohol
Who is included in the fall MDT?
Nurse, physiotherapist, doctor and MDT discussion
What is included in the systemic enquiry following a fall?
Memory, urinary symptoms, has walking changes, drugs and alcohol
What is included in the examination following a fall?
Head and arms - cranial nerves, neglect, rigidity and cerebellar signs
Pulse and heart sounds
Kyphosis and abdominal exam
Legs and feet - coordination and sensation
Romberg’s and assess gait
What investigations are done following a fall?
ECG
Bloods - FBC, U+Es, LFT, Ca, CRP, PV, B12, folate, folic acid and TFTs
When is an ataxic gait seen?
Cerebellar damage
What is a hemiplegic gait seen?
Stroke
When is a high stepping gait seen?
Peripheral neuropathy
What should be done if there was a long lie after the fall?
CK checked for rhabdomyolysis
Also pneumonia and skin injury
How is a fallen person assessed in A+E?
ABCDE approach
Check glucose
Top to toe survey
What is included in the immediate assessment for serious injuries?
Head injury and extra dural, seizure, C spine injury, flail chest, abdominal injury, pelvic injury and limb fracture
When should a head CT be done?
Low GCS < 13
Still confused after 2 hours
Focal neurology
Signs of skull fracture
basal skull fracture
Seizure, vomiting and anti-coagulation
What is included in the falls prevention care plan?
Ensure vision and mobility aids are in reach
Consider bed rails, regular obs and tell people
