Falls Flashcards
what are the implications with immobilisation
hypothermia dehydration pressure sores rhabdomyolysis venous thromboembolism bronchopneumonia muscular de-conditioning
what factors cause people to fall
person factors
environment
activity
what person factors contribute to falls
physiology of ageing
pathology associated with ageing
what age related physiology increases falls risk
decreased reaction time smaller pupils - decreased light decreased cardiorespiratory fitness sarcopenia decrease peripheral sensation and proprioception
common causes of falls and syncope
Arrythmia Orthostatic hypotension Neurogenic Carotid sinus hypersensitivity Valvular heart disease
what is orthostatic hypotension
Fall in SBP >20 mmHg or fall in DBP >10 mmHG after 3 mins of standing
what does cognitive impairment impair
judgement
visual-spatial perception
orientation
what exam needs to be done for anyone who falls
neurological exam
vestibular causes of ‘dizziness’
Benign paroxysmal positional vertigo
treat with epley manoeuvre
what are the extrinsic risk factors for falls
Medication Alcohol Environmental hazards Inappropriate clothing/footwear Inappropriate walking aids
what medications commonly increase falls risk
benzodiazepines neuroleptics antihypertensives antidepressants anticholinergics class 1A antiarrythmics
what is involved in a falls assessment
history
examination
establish all risk factors
targeted investigation and occupational health assessment
what assessment tools are used in a falls assessment
TUG - timed up and go test (how long it takes to stand up, walk 3m, turn round and come back)
Berg balance scale
Tinetti score
when do a fracture risk assessment score
for everyone who has a fall
-diagnose and treat osteoporosis
interventions to prevent further falls
Strength and balance training Environmental modifications Footwear and foot care Vision optimisation Patient education and treatment Medication review
