First aid: when is a fall an emergency?
A fall that results in injury can cost lives. Alarming statistics tell us that, globally, an estimated 646,000 fatal falls occur each year, representing the second leading cause of death from unintentional injuries, after road accidents. (WHO 2018)
A fall is defined as an unplanned descent to the floor, ground or other lower surface with or without injury to the patient.
Anyone who falls is at risk of injury, but factors such as age, gender and existing medical conditions influence the type and severity of injuries.
Even in the absence of injury, a fall affects quality of life
Elderly people fear falling and consequently tend to limit physical activities and social engagements.
This leads to a deterioration of physical and mental well-being, social isolation and a feeling of helplessness and anxiety.
What are the conditions that make falls more likely?
The causes of falls are many and are classified as risk factors.
However, many risk factors can be modified to help prevent falls, such as:
- occupations at high heights or other dangerous working conditions
- Alcohol or drug use
- Underlying medical conditions, such as neurological, cardiac or other disabling conditions
- Side effects of medication, physical inactivity and loss of balance, particularly among the elderly
- Poor mobility, cognition and vision, particularly among those living in an institution, such as a nursing home or chronic care facility
- Weakness in the lower body
- Vitamin D deficiency
- Foot pain or inadequate footwear
- Risks or hazards in the home, such as uneven steps or clutter that one may trip over.
(NCOA 2018)
What can happen after a fall?
In many cases, falls do not cause injuries.
However, 1 in 5 falls result in a serious injury, such as a broken bone or head injury.
These injuries can make it difficult for a person to move around, perform daily activities or live alone.
Falls can cause
- Bone fractures, such as fractures of the wrist, arm, ankle or hip.
- Head injuries, which can be very serious, especially if the person is taking certain medications such as anticoagulants, etc.
- Many people who fall, even if they are not injured, are afraid of falling.
(Namkee 2019)
Recommended steps to prevent serious consequences of a fall
Make an appointment with the doctor – A fall at home due to loss of balance is always worrying.
Especially if it is not caused by an accident or a tripping hazard.
The first step is always to talk to your doctor.
Be prepared to answer questions such as your medical history, medications you are taking, previous falls, etc.
Once your doctor understands the specific factors that contribute to your risk, it becomes easier to focus on a fall-prevention diagnosis or medication modification.
Keep active – It is important to realise that incorporating exercise into your daily routine can be of great help.
Discuss this with your doctor and, once you get the go-ahead, start with activities such as walking, water exercise or tai chi, a gentle exercise that involves slow, graceful movements similar to dancing.
These activities reduce the risk of falls by improving strength, balance, coordination and flexibility.
If you are being treated by a physiotherapist, they can create a customised exercise programme to improve your balance, flexibility, muscle strength and gait.
Wear comfortable footwear – Shoes may seem like a less important accessory, but they can save you from many aches and pains, if not your life!
High heels, floppy slippers and shoes with slippery soles can make you trip and fall.
Instead, wear comfortable shoes with non-slip soles.
In addition, keeping your shoes light makes it easier for your feet to move, reducing the chance of dragging and tripping.
Eliminate house hazards – The quickest way to prevent falls is to do a quick tour of the house and clear clutter, especially from hallways and stairs.
You can also examine each room and hallway, looking for items such as loose carpeting, slippery rugs or misaligned wooden planks.
Repairing, removing or replacing these items will greatly improve fall prevention.
Use assistive devices – Your doctor may recommend the use of a cane or walker to keep you upright.
Other assistive devices can also be useful, such as handrails for both sides of stairs, handrails in showers and baths, non-slip treads for bare wood steps, etc.
(NIA 2017)
What can we do to prevent falls?
Families with elderly parents or relatives living alone would do well to make an assessment of falls in the home, eliminating trip hazards, installing handholds and handrails and looking for potential hazards.
Discuss mobility with them and insist that they ask for help when doing tasks such as changing ceiling light bulbs or cleaning outdoor areas that require a ladder.
Take a minute to introduce yourself to the neighbours to the right and left of your family member and ask if they are willing to exchange phone numbers and help with a simple household task out of reach.
Families with young children can create a night-time routine and check for toys and debris in the communal paths or on the stairs.
Make it a competitive and fun activity: keep a tally of who can secure the most toys, tally at the end of the week and reward with a small privilege or an extra dollar in pocket money.
Use your imagination, know what motivates your children!
Do-it-yourselfers who like to do interior and exterior maintenance work that requires a stool or ladder, make sure to follow the safety measures for ladders.
Cleaning gutters, power washing and hanging lamps may seem like a simple task to some, but falls from ladders are one of the biggest fall hazards leading to visits to the emergency room.
Accidental falls, in conclusion
Falls that result in head injuries, possible fractures or large bruises require immediate emergency room attention.
Keep your home safe from tripping hazards and remove debris that may be invisible at night or create obstacles for residents with special needs.
Let’s stay safe together and, if we intentionally take care of our home’s passageways, hallways and common areas, we can prevent medical emergencies due to trips and falls.
References
“Falls.” World Health Organization, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/falls.
“Important Facts about Falls.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Feb. 2017, https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html.
“Falls Prevention Facts.” NCOA, 4 June 2018, https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/.
Choi, Namkee. Fall-Related Emergency Department Visits and Hospitalizations among Community-Dwelling Older Adults: Examination of Health Problems and Injury Characteristics. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1329-2#citeas.
“Prevent Falls and Fractures.” National Institute on Aging, U.S. Department of Health and Human Services, https://www.nia.nih.gov/health/prevent-falls-and-fractures.
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