Falls Flashcards
what do you ask about before a fall?
warning
dizziness
chest symptoms - pain/palpitations
WDC
what do you ask about during a fall?
LOC duration injury + what body part hit first pallor/flushed - ?vasovagal seizure sx - limb jerking, incontinence + tongue biting
L-DIPS
what do you ask about after a fall?
confusion - ?head injury able to get up? time until? resumption of normal activities - ability drowsiness stroke sx - weakness/speech
CARDS
how can diabetes cause a fall?
hypoglycaemia
neuropathy
retinopathy
falls risk assessment - social history
Footwear
Living situ - who with, support, stairs, furniture/clutter, lighting
ADL - washing, dressing, shopping, cooking
Alcohol
Mobility
Exercise - increases muscle strength + reduces frailty + falls risk
FLAAME
what medications can increase falls risk?
polypharmacy (>5)
antihypertensives - hypoT benzos - sedation beta blockers - brady corticosteroids - osteoporosis diabetic meds - hypo ABBCD
significance of antibiotics + bisphosphonates in falls history/risk assessment
antibiotics - infection -> delirium
bisphosphonates - reduce fracture risk but indicate osteoporosis
how do you do a timed up and go?
timed up + go - get up without arms, walk 3m + back
turn 180 - more than 4 steps
what investigations would you offer for a falls risk assessment?
examination - timed up + go, visual, neuro
assessments - cognitive screening, continence
bedside - ECG, glucose, obs (lying + standing BP), urine dip
bloods - FBC + U+E (infection, anaemia, derangements)
imaging - CXR, CT head
refer - optician, hearing
reducing falls risk - management
bedside assessments - medication review, continence
medical - hydrate + nutrition, ABX
lifestyle - footwear, walking aids, home mods (OT - lighting, obstacles)
refer - psych, sight, hearing
falls - recent PMH
pain
infection/fever
weight loss, night sweats, fatigue
Causes of delirium
Pain Infection Nutrition Constipation Hydration Medication Environment
PINCH ME
CAM
1 - acute onset + fluctuating course
2 - difficulty focusing attention
3 - disorganised/incoherent thinking
4 - altered consciousness
coma - unarousable stupor - difficult to arouse lethargic - drowsy, easily aroused alert - normal vigilant - hyperalert
CAM - 4 key things
Acute onset + Fluctuating course
Consciousness altered
Attention difficulty
Disorganised thinking
AF-CAD
AMT-4
DOB
Age
Place
Year
DAPY
