Falls Flashcards
What are some causes of dizziness?
Psychogenic
Unsteadiness
Vertigo - BPPV, menieres, acoustic neuroma
Presyncope
What interventions can be used to prevent falls?
Strength and balance training
Home hazard assessment
Vision assessment
Medication review
What is FRAX10?
Scoring for osteoporosis
Gives 10 year fracture risk
What is the treatment for osteoporosis?
Alendronic acid 70mg once weekly
Calcium
Vitamin D
How can falls be prevented?
Ask over 65s routinely if they have fallen
Offer multifactorial falls assessment
What investigations should be done after a fall?
ECG
FBC, U and Es
Blood sugar
Lying and standing BP
TFTs, B12, folate, HbA1c - if peripheral neuropathy
Dix-hallpike - if vertigo
Consider echo
What drugs can contribute to falls?
Antihypertensives
Sedatives
Opioids
Psychotropics
What ageing factors can contribute to falls?
Vision changes Cognitive decline Sarcopenia Osteoarthritis Reduced baroreceptor sensitivity
What medical factors can lead to falls?
Cardiac - hypotension, arrhythmias
Neurological disease - neuropathy, stroke, Parkinson’s
Endocrine - hypoglycaemia
What environmental factors can contribute to falls?
Walking aids
Footwear
Home hazards
What systems should be examined after a fall?
Cardiorespiratory - pulse, listen to heart and chest, lying and standing BP
Neurological - gait, power and sensation
Musculoskeletal - knees and hips
Vision
What is the treatment for drug factors after a fall?
Prescription review
What is the treatment for ageing factors after a fall?
Balance retraining
Visual acuity testing
Calculate FRAX 10
What is the treatment for medical factors after a fall?
Referral/control of chronic conditions
Address osteoporosis risk
What is the treatment for environmental factors after a fall?
Home visit by OT
Consider panic alarm/care call system
