Falls

Differential diagnosis

• Cardiovascular
  • MI
  • Arrhythmia
  • Postural hypotension
• Neurological
  • Epilepsy
• Infections
  • UTI
• Others
  • Medications, vision, balance, hazards at home

Data gathering

• Red flags – palpitations, chest pain, LOC, urinary incontinence
• Others – Shx: stairs
• Examine – L/S BP, pulse, temp, CVS, CN/PNS/Gait, urine dip

Clinical management

• Investigations
  • Bloods – FBC, U+E, LFTs, TFTs, B12, folate, HbA1c
  • Urine dip
  • ECG

• Explanation
  • lots of things that increase risk of falls – certain medications (b-blocker, insulin), alcohol, diabetes, problems with vision and balance

• Treatment
  • Refer falls clinic
  • Optician
  • Physio – strength and balance training
  • OT – hazard assessment, walking aids
  • GP – osteoporosis risk

• Follow-up / Safety net
  • Osteoporosis review followup
  • Regular reviews