Focus on key historical factors that increase fall risk
Key historic elements include
Depending on circumstances, also consider EKG, complete blood count, standard electrolyte panel, measurable medication levels, and appropriate imaging.
In a paper by Southerland, a 4-stage balance test in addition to the STEADI screening questions significantly increased the detection of older adults at risk for falls.
We need to get our patients UP to assess their functional status and fall risk.
Rosenberg MS et al. American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, Society for Academic Emergency Medicine. 2013: https://www.acep.org/globalassets/uploads/uploaded-files/acep/clinical-and-practice-management/resources/geriatrics/geri_ed_guidelines_final.pdf.
Southerland LT et al. Am J Emerg Med. 2017;35(2):329–332.
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148.
ACEP, American College of Emergency Physicians; AMS, altered mental status; ED, emergency department; EKG, electrocardiography; STEADI, Stopping Elderly Accidents, Deaths & Injuries.