Synopsis
Treat a fall as an event requiring acute injury and cause assessment, reconstruct baseline and circumstances through collateral, and deliver a personalised multifactorial prevention plan that improves strength, balance, confidence, bone health and home safety.
- A fall is an event, not a diagnosis: reconstruct what happened before, during and after and compare current mobility with the stable baseline.
- First-line acute assessment is ABCDE, glucose, injury and head-impact review, pain relief, medication check and evaluation for syncope, stroke and illness.
- Ask about falls in the past year, near-falls, ability to get up, long lie, footwear, alcohol, continence urgency, vision, hearing and fear.
Key red flags
Head strike, anticoagulant or antiplatelet use, vomiting, amnesia, focal deficit or reduced consciousness requires urgent head-injury assessment.
Delirium, hypoxia, fever, glucose disturbance or new functional loss indicates illness-triggered instability.
Investigation priorities
Identify immediate illness and trauma.
Management branches
An older adult presents after a fall or near-fall.
- Stabilise, check glucose, treat pain and evaluate head, hip and other injury and acute illness.
- Obtain witness and baseline collateral and assess syncope, seizure, medicines, gait, cognition, vision and environment.