Managing falls Flashcards
1
Q
why is history taking important in falls?
A
- to differentiate the type and cause of falls.
2
Q
what are the 5 factors that are important in history taking?
A
who? patient and witness.
when? did the patient lie on the ground for long.
where? place.
what? how were they feeling, medication etc before/ during fall, incontinence, landing/ assistance, consciousness, pain after.
how? how often has patient fallen over past few months?
3
Q
what systems are considered in a fall?
A
- CVS: chest pain, SOB, palpitations.
- Respiratory: SOB, pleuritic chest pain, sputum, COPD.
- Neurological: dizziness blurred vision, memory, loss of sensation, headache.
- Genitourinary: urine output, incontinence, pain, difficulty urinating.
- GI: bowel habit changing, nausea, blood in stool, anyone at home unwell.
- MSK: joint pain, stiffness.
4
Q
compare syncope vs non-syncope falls?
A
- syncope: transient loss of consciousness due to less cerebral blood flow.
- non syncopal: loss of consciousness not due to cerebral hypo-perfusion.
5
Q
what is syncope?
A
- neurally-mediated: vasovagal, carotid sinus, situational cough.
- orthostatic hypotension: drug induced, ANS failure, volume depletion.
- cardiac arrhythmia: bradycardia, tachycardia, inherited.
- structural cardio-pulmonary: Acute MI, aortic stenosis.
6
Q
what could cause a non-syncope fall?
A
- without consciousness impairment: tripping over, TIA, stroke.
- with consciousness loss epilepsy, intoxications, metabolic.
7
Q
how would we assess falls?
A
- heart rhythm, chest sound.
- abdominal tenderness.
- review medications.
