Falls Flashcards
Wat are the factors hat need to be considered around a fall
Who - did anyone else see, if yes collateral history
When - ight? What were they doing at the time//
Where? Which rom, trip hazards, lights etc
What - prior symptoms, pain? During - loc? Incontinence, TOUNGE bite, after 0 regain consciousness, confusion?
How - low long, how many iMessage, any serious injuries
What is that most important part of a fall history
Presence or absence of loc leading to fall
What is syncope
A transient loc characterised by fast onset and spontaneous recover y
Caused by reduced perfusion pressure in pain
Self limiting - being horizontal will fix
Whar are the symptoms preceding a syncoa episode
Light headedness, sweating, pallor, blurred vision
What are seizures
A generalised tonic-clinic lecture is a cause of loc and will cause a fall
However is not syncope
Be aware of epilepsy in the elserly
Seizures can be subtle
Whar are categorie f syncope
Reflex, orthostatic hypotention, cardiac/pulmonary disease
Wha is reflex syncope
Disorder if the autonomic regulation of postural tone. Activation of part of the medulla leas toecrease in sympathetic output and increase in parasympathetic. Fall in co and bp leads to less cerebral perfusion
Eg baso vagal, situational, carotid sinus massage
Whar is orthostatic hypotension
After standing froma sittin or lying position. Can cause syncope if by is severe enough, with pre syncopal symptoms on standing
Standing up causes 500-800 ml o bloodto pool in the leafs, reduced edge, reduced cardiac stress, so reduced sv and co, normall mnaged by baroreceptor reflex - if this failed cerebral perfusion will drop
Ive an overview of the baroreceptor reflex
SS
Why does the baroreceptor reflex fail
Become less sensitive with age, also with hypertension
Anti hypertensives can impair the response
Dehydration
What is cardiac syncope
Caused by cardiac disease or abnormality. Can be electrical rhythm, structurel or coronary cause
Electrical - tachycardia or bradycardia
Structural - aortic stenosis, hypertrophic obstructive cardiomyopathy
Coronary - mi/hd.
What are features of cardiac syncope
Exertional, FH of cardiac disease o sudden cardiac death, preceding chest pain or palpitations, pmh of hd, abnormal ecg
What are non syncopal fall
A fall in which the cause is not syncope. A fal with a loc following a head trauma is still a no-syncopal fall (loc after fall). Trips ad slips fall in this category. Often the fall can be the en result of inter current illness suc as infection
Describe multiactorial falls
Result of more than one thing. Eg osteoarthritis and diabetic neuropathy. + infection
Describe the drug history
Polyphamacy, new meds, anti hypertensives/anti-arrhythmia - long term??
Drugs which may induce drowsiness??? Eg new analgesia, benzodiazepines, antidepressants, antipsychotics etc
