falls Flashcards
history that would help you determine cause of her falls?
I would ask for a detailed past medical history and medication list. I would be sure to ask specifically about antihypertensive medication and whether anything new had been started in the days/weeks prior to the fall. I would like to know specifically about her diabetic control and whether she uses insulin.
explore her social history. Where does she live, accommodation type, who with, any care in place? What is her mobility like at baseline – any aids or independent? I would also ask about alcohol use at this point.
o complete my history, I would conduct a quick cognitive screening assessment.
Would you order a CT head?
would be based on my history, examination and investigation conducted in clinic. If there is a history of head injury associated with loss of consciousness or change in cognitive function, I would consider a CT head. If the patient is on any anticoagulant medication this would also change my thinking. I would discuss this request with my senior colleagues before ordering it.
recently been put on rivaroxaban for atrial fibrillation. After her first fall she hit her head and she has been increasingly confused. Would you order a CT head?
I would be concerned about her having a subdural haematoma or intracranial bleed which could have occurred when she hit her head when falling with an increased risk due to her use of a direct-acting oral anticoagulant. She would meet the NICE criteria for arranging a CT head given her age profile and change in cognitive function.
