Elderly Emergency Department Falls patients falls elderly emergency department FREED
Conditions
Interventions
Intervention
I. Medications:
A. Is the patient taking psychoactive/sleep aid medications?
If yes,
communicate with primary physician with recommendations on how medications can be adjusted
B. Is the patient taking vitamin D?
If not,
recommend Vitamin D,
1000 units daily or calcitriol 25 microgram
II. Does the patient have orthostatic hypotension? (drop in systolic blood pressure from lying to standing > 20 mm Hg or light headedness)
If yes,
a) give support hose to patient
b) encourage hydration,
(e.g. eight 8-
ounce glasses of water daily unless patient advised to limit fluid intake such as with congestive heart failure).
Is the patient taking multiple anti-
hypertensive medications?
If yes,
communicate with primary physician to see if medications can be adjusted
III. Management of physical limitation
Refer patients to evidence-
based physical therapy
IV. Environmental safety
Community base referral to visiting nurse for home safety evaluation and handout on home safety.
For the rehabilitative exercise component,
we will refer patients to physical therapy clinicians that provide evidence based programs for fall patients.
,Intervention
I. Medications:
A. Is the patient taking psychoactive/sleep aid medications?
a) give support hose to patient
b) enc
Sponsors
Navamindradhiraj University Research Fund
Navamindradhiraj University Research Fund
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients age 65 years and older who presenting with unintentional fall to the ED. 2. Patients have fall history within 7 day prior ED visit.
Exclusion criteria
Exclusion criteria: 1. Patients who refuse consent 2. Patients whose unintentional falls resulted from a major health event (e.g. myocardial infarction) or overwhelming external hazard. 3. Severe trauma 4. Patients who do not live in the community 5. Patients who have lower extremity and spinal fractures that require surgery, head injuries that require admission (given these patients will likely have a long encounter in a rehabilitative center) 6. Patients deemed too unstable according to the clinician judgment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recurrent falls 1,6, 12 months Telephone follow up and fall calendar | — |
Secondary
| Measure | Time frame |
|---|---|
| ED revisits, subsequent hospitalization, death 1,6, 12 months telephone follow up, medical record | — |
Countries
Thailand
Contacts
Public ContactJiraporn Srion
Vajira Hospital, Navamindradhiraj University
Outcome results
None listed