Falls

Question 0

What are some of the risk factors for falls?

Answer 0

• alcohol
• syncope
• Parkinsonian effects
• gait disturbance/ataxia
• osteoporosis (increased risk of fracture)
• bleeding disorder (increased risk of cerebral haemorrhage)

Question 1

Give some examples important medications to think about with falls.

Answer 1

• gentomycin (ototoxcity -> reduction of vestibular system)
• anti-hypertensives (overtreatment -> postural hypotension)
• ACE inhibitors (hypotension)
• beta-blockers (hypoglycaemia)
• diuretics (dehydration)
• nitrates (hypotension)
• tri-cyclic antidepressants/anti-psychotics (sedation/drowsiness + impaired decision making)
• steroids (osteopenia)
• warfarin/aspirin (GI bleeds -> hypotension)
• analgesics/opiates (sedation/drowsiness)

Question 2

What are some important questions to ask when someone falls?

Answer 2

• lost consciousness? before/after fall
• able to get back up?
• fallen before?
• any pain? location/intensity?
• medications?
• medical conditions?
• what were they doing at the time?
• environment e.g. lighting, stairs, carpets, walking sticks, etc.

Question 3

What are some of the mechanisms behind a fall?

Answer 3

• central processing (integrates sensory inputs and coordinates effector mechanisms)
• vision
• vestibular system
• gait
• muscle strength
• proprioception

Question 4

What are some of the interventions for falls?

Answer 4

• increase bone strength
• hip protection
• occupational therapy -> change environmental factors
• physiotherapy -> strength & balance training
• medication review