Falls

Question 1

Falls Risk Factors

Answer 1

• Age >80
• Female gender
• Low weight
• PHx
• Dependency
• Orthostatic hypertension
• Medication (leading culprits are psychotropics (benzos, antidepressants, antipsychotics), blood pressure lowering drugs and anticonvulsants..

Question 2

Falls Risk of Injury

Answer 2

• Weak bones
• Osteoporosis, osteomalacia, Paget’s, metastases
• Predisposition i.e. dementia causing impaired visuospatial ability
• Poor self protection
• Lack of SC fat, neurological problems (preventing reflex breaking), LOC, motor and sensory problems,

Question 3

Falls History

Answer 3

• OPERATES
• LOC?, before during after, collateral
• PMHx; heart disease, DM; increased risk of arrhythmias, TIA, stroke
• Appetite, functional status, mental faculties
• Mental state, visual impairment, CVS, neurological

Question 4

Falls Drop Attacks

Answer 4

CVD, carotid sinus hypersensitivity, TIAs, orthostatic hypotension

Question 5

Falls Ix

Answer 5

• Bloods
• Urinalysis (vascular disease from diabetes)
• ECG
• Echo if indicated (e.g. AF)
• Visual assessment
• CT head if: anticoagulated, 2 or more vomits, focal neurology, suspected fracture, GCS reduced by 1, seizure

Question 6

Falls Aetiology

Answer 6

• Mechanical
• Dehydration
• Postural hypotension
• Confusion
• Arrhythmia
• Aortic stenosis

Question 7

Falls Prevention

Answer 7

• Strength and balance training
• Home hazard intervention and follow up
• Medication review
• Cardiac pacing where indicated