The best care for treating elderly falls patients

Responding to elderly patients who have fallen makes up a huge proportion of the 999 calls the Trust attends and can have a huge impact on the quality of life and the future health of the patient. A fall of more than two metres can also cause major trauma, in the form of traumatic head injuries or subdurals, which can often be undiagnosed.  

The National Institute for Clinical Excellence (NICE) guidelines state that older people who call 999 because of a fall or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment.

This assessment should be performed by a healthcare professional with appropriate skills and experience, normally a specialist falls service. This assessment should be part of an individualised, multifactorial intervention. 

Therefore, we should be referring all patients over 65 who have fallen to the Trust’s single point of contact (SPOC - 0845 602 6856) even if they have been referred previously, to ensure the patient is added to the falls register and to notify their local GP or falls team.

The SPOC number is programmed into your radios - please ask your manager for assistance if needed.

Please remember to record the following when attending a fall if you do not convey to hospital:

• pulse rate
• respiratory rate
• blood pressure (this must be a full arterial reading measured by a sphygmomanometer expressed as systolic/diastolic (e.g.120/80), not a palpated measure expressed as, for example, <90
• level of consciousness (either AVPU or GCS)
• blood glucose.

If you suspect the patient has fallen due to a medical condition, a 12-lead ECG assessment should also be recorded to rule out any cardiac involvement. If you do not carry out this assessment, please document your reasons why you felt this was not appropriate.

You should also record your assessment of the patient’s mobility, including what is normal for the patient.

For more information or to read the national guidance relating to falls, please visit the NICE website.