Falls Flashcards
1
Q
what factors would you focus on when taking a falls history?
A
*cause, consequences, prevention of further
- before, during and after
- aftermath - pain, recurrent falls, confidence
- previous falls
- ICE
- systemic inquiry
- fracture risk - FRAX
- PMH, DHx, FHx, Sx
2
Q
what score is used to assess risk of recurrent falls?
A
FRAT score
- have you had any falls in the last year?
- are you on 4+ medications?
- do you have a diagnosis of stroke or Parkinson’s?
- are you able to get up from chair without using your arms?
<3 low risk & 3-5 high
3
Q
what types of conditions do you focus on in the PMH section?
A
- conditions affecting mobility, strength or balance
- affecting cognition
- affecting sensory elements
- conditions that lead to urgent movement
- CVS
4
Q
what types of drugs are revenant when investigating causes of falls?
A
- antihypertensives
- sedating drugs
- diuretics
- antidepressants (SSRI)
- anticholinergics: cause dizziness, affects vision etc
5
Q
what kind of broad causes are there for falls in the elderly?
A
- cardiac: arrhythmia
- neurological: stroke, neuropathy
- vasovagal
- intoxication - alcohol, pharmacological
- ENT: BPPV
- infection: UTI
- endocrine: hypoglycaemia
- MSK: arthritis
- environmental - lighting, uneven surfaces
6
Q
what examinations would you carry out in someone who’s suffered a fall?
A
- CVS, RESP
- GALS
- ECG
- BP lying and standing
- urine dip
- neuro
- ENT
7
Q
what investigations would you carry out in a patient who has suffered a fall?
A
- bloods: U&E, CRP, WCC, CK
- cognitive screen: AMT
- XR
- echo
- 48h cardiac tape
- CT, MRI head
- Dix-hallpike
- ACTH stimulation test?
8
Q
how would you manage a fall?
A
- treat underlying cause: infection, ENT
- treat aftermath: fractures
- med review, visual review
- alcohol detox
- OT review on house
- cognitive assessment
- physio rehab
