Retiring the Term “Mechanical Fall” for Older Patients

With Dr. Shan Liu

Christina Shenvi

ED physicians and APPs see older patients in the ED for falls every. single. shift. On this episode, geriatric EM expert Shan Liu talks about preventing future falls from the ED, and the fact that we should retire the term “mechanical fall”. Unfortunately, this term is potentially misleading and can downplay the serious nature of the patient’s falls risk.

Falls are very common among older adults and come with a high risk of future falls and also of trauma-related morbidity and mortality. There is more we could be doing in the ED to prevent future falls.


  1. Geriatric ED Guidelines, from ACEP, AGS, ENA, and SAEM
  2. Nagaraj G, Hullick C, Arendts G, Burkett E, Hill KD, Carpenter CR. Avoiding anchoring bias by moving beyond ‘mechanical falls’ in geriatric emergency medicine. Emerg Med Australas. August 2018.
  3. Tirrell G, Sri-on J, Lipsitz LA, Camargo Jr CA, Kabrhel C, Liu SW. Evaluation of older adult patients with falls in the emergency department: discordance with national guidelines. Acad Emerg Med. 2015;22(4):461-467.
  4. Sri-On J, Tirrell GP, Kamsom A, Marill KA, Shankar KN, Liu SW. A High-yield Fall Risk and Adverse Events Screening Questions From the Stopping Elderly Accidents, Death, and Injuries (STEADI) Guideline for Older Emergency Department Fall Patients. Geson LW, ed. Acad Emerg Med. 2018;25(8):927-938.
  5. Liu SW, Obermeyer Z, Chang Y, Shankar KN. Frequency of ED revisits and death among older adults after a fall. Am J Emerg Med. 2015;33(8):1012-1018. doi:10.1016/j.ajem.2015.04.023.
  6. Shankar K, Liu S, Ganz D. Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003-2010. West J Emerg Med. 2017;18(5):785-793.
  7. Shankar KN, Taylor D, Rizzo CT, Liu SW. Exploring Older Adult ED Fall Patients’ Understanding of Their Fall: A Qualitative Study. Geriatr Orthop Surg Rehabil. 2017;8(4):231-237.

This podcast uses sounds from by Jobro and HerbertBoland

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Christina Shenvi


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

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