Falls Hx

Question 1

Questions to ask BEFORE the fall happened

Answer 1

What time of day?
Where did it happen?
Home or outside?
If at home, where?

What were you doing?

Any chest pain, dizziness, palpitations?

Question 2

Questions to ask if patient says they were dizzy

Answer 2

Did the room spin?
Any hearing loss? Any tinnitus?
Any change in vision?
Any vomiting?

Question 3

Questions to ask about DURING the fall

Answer 3

Were there any witness?
Any LOC?
Any incontinence or tongue biting?

Which part of the body had first contact with the floor?
Any injuries?

Question 4

Questions to ask about AFTER the fall?

Answer 4

Any confusion?
Any weakness or speech difficulty?

How long to recover consciousness?

How long were you on the floor for?
Were you able to get up by yourself?
Did you have an alarm?

Question 5

Systems Review

Answer 5

Head – LOC? Seizure? Stiff jerky movements? Dizziness?

Heart – Chest pain, palpitations?

Lungs – SOB, Cough?

Abdo – N+V? Abdo pain? Constipation?

Urinary – Incontinence? Dysuria? Frequency?

MSK – Joint pain? Muscle weakness?

Red flags – fever, fatigue, weight loss?

Question 6

PMH General Questions

Answer 6

Visual/hearing impairment
Anaemia
Diabetes
Problems with balance

Question 7

PMH Systems Questions

Answer 7

Neuro – Previous strokes? Dementia? PD?

Cardio – Arrythmias?

Respiratory – COPD?

Abdo – Alcoholic liver disease?

Urinary – recurrent UTIs?

MSK – OA? Any previous fractures?

Question 8

Social History Questions

Answer 8

Alcohol intake
Who’s at home?

Mobility aids? When do you use them?

Do you have easy access to loo and shower?

Question 9

Drug History Questions

Answer 9

Any allergies?
Any new medications?

Beta blockers?
Blood pressure drugs?

Diabetes medications?

Benzodiazepines?

Question 10

ICE

Answer 10

Loss of confidence?

Change in behaviour?

Question 11

What bedside investigations would you order?

Answer 11

Vital signs - sepsis, bradycardia

LSBP - postural hypotension

ECG - arrythmias, bradycardia

AMTS – cognitive impairment

BMs – hypoglycaemia

Question 12

What bloods would you order?

Answer 12

LFTS – chronic ETOH excess

FBC – anaemia, infection

Bone profile – calcium abnormalities

Urinalysis – MC+S, look for UTI

U+Es – dehydration, electrolyte imbalance, rhabdomyolysis

Question 13

What imaging would you order?

Answer 13

CT head - drop in GCS, head injury

Echo - for valvular heart disease