Preventing Falls in the Elderly: An EMS Story

With David Silfen

The risk of falls increases as we age. Unfortunately, so does the risk of injury, morbidity, and mortality following a fall. Falls risk is considered a geriatric syndrome, with multi-factorial causes. Falls are a the #1 cause of trauma-related mortality in older adults, and a major cause of ED visits, hospital admissions, and admission to nursing facilities. Often, a patient at high risk for falls is not identified until after they have suffered an injury. Orange County EMS developed a system to help identify patients who were at high risk for falls, perform a comprehensive home visit, and connect those individuals with appropriate services to help reduce the rate of future falls and help those patients maintain their independence and functionality in their home environment.

References

  1. The MRC CRASH Trial Collaborators. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ 2008 Online calculator
  2. Tinetti ME, Inouye SK, Gill TM, et al. Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA 1995;273(3):1348–1353. https://www.ncbi.nlm.nih.gov/pubmed/7715059
  3. Haentjens P, Magaziner J, Colon-Emeric CS, et al. Meta-analysis: Excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152(6):380-390 https://www.ncbi.nlm.nih.gov/pubmed/20231569
  4. Peck et al. Death after discharge: predictors of mortality in older brain injured patients. J Trauma Acute Care Surg 77;6, 2014 https://www.ncbi.nlm.nih.gov/pubmed/25248061
  5. CDC TBI facts and stats http://www.cdc.gov/traumaticbraininjury/index.html
  6. National Council on Aging Fall Prevention Facts and Statistics https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/
  7. Falls in Older Persons: Risk Factors and Prevention.https://www.ncbi.nlm.nih.gov/books/NBK235613/
  8. Zia et al. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk. Postgrad Med  2015127 (3) https://www.ncbi.nlm.nih.gov/pubmed/25539567
  9. AHRQ Statistical Brief #268: Outpatient prescription anticoagulants utilization and expenditures for the US civilian noninstitutionalized population age 18 and older, 2007

 

This podcast uses sounds from freesound.org by Jobro and HerbertBoland.

Image credit [1]

This entry was posted in Medications and Adverse Drug Events, Systems and Administration, Trauma. Bookmark the permalink.

Hosted by

Christina Shenvi

MD, PhD, FACEP
Bio

Dr. Christina Shenvi is an associate professor of Emergency Medicine at the University of North Carolina. She is fellowship-trained in Geriatric Emergency Medicine and is the founder of GEMCast. She is the director of the UNC Office of Academic Excellence, president of the Association of Professional Women in Medical Sciences, co-directs the ACEP/CORD Teaching Fellowship, is on the Annals of EM editorial board, is on the Geriatric ED Accreditation board of governors, and she teaches and writes about time management at timeforyourlife.org.

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