Falls and immobility Flashcards
What are some risk factors for falls?
Muscle weakness
History of falls
Gait deficit
Balance deficit
What are the categories of causes of falls?
Intrisic
Extrinsic
Situational
What are the instrinsic causes of falls?
Gait and balance problems Syncope Chronic disease Acute disease Visual problems Cognitive disorder Vit D deficiency
What are the common gait and balance problems?
Postural instability
Vertigo
What maintains postural stability?
Cardiac output
Vasomotor tone
What are the controls of balance?
Sensory inpout- visual, vestibular, proprioceptive
Central processing
Muscular activity
What are the causes of vertigo?
Labrynthitis Acute ear infection Benign paroxysmal positional vertigo Meniere's Cerebellar/brainstem pathology
How are gait and balance problems assessed?
Sitting to standing ability Static standing balance Romberg test Dynamic standing balance Gait Timed up and go test
What are the causes of syncope?
Neurally mediated Orthostatic hypotension Cardiac arrythmias Structural cardiac or cardiopulmonary disease Cerebrovascular
What are the common causes of neurally mediated syncope?
Vasovagal syncope
Carotid sinus hypersensitivity
Situational syncope
What are the causes of orthostatic hypotension?
Autonomic failure
Volume depletion
What is the most common cause of syncope?
Vasovagal syncope
What are the common causes of syncope in older people?
Vasovagal
Orthostatic due to autonomic failure
What should be assessed in syncope?
PMH
History of event- prodrome, last and first thing remembered, circumstances, posture, injuries, confusion/weakness
ECG
What chronic diseases can cause falls?
Neuro
MSK
What cognitive disorders can cause falls?
Dementia
Delirium
Depresison/anxiety
What extrinsic factors can cause falls?
Inappropriate footwear
Environmental hazards
Poor lighting
What are the situational causes of falls?
Drugs
Alcohol
Urgency of micturition
What medications can cause falls?
Antidepressants Antipsychotics Anticholinergics/antimuscarinics Benzodiazepines Antihypertensives Diuretics
What are the outcomes of falls?
Injury- soft tissue, fracture, subdural etc Rhabdomyolysis Loss of confidence Inability to cope Dependency, decreased quality of life Carer stress Institutionalisation Terminal decline
What are the categories of complications of immbolity?
Physical
Psych
Social
What are the physical complications of immobility?
Muscle wasting Muscle contractures Pressure sores DVT Constipation/incontinence Hypothermia Hypostatic pneumonia Osteoporosis
What are the psych complications of immobility?
Depression
Loss of confidence
What are the social complications of immobility?
Isolation
Institutionalisation
