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Intro
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Causes & Prevention of Falls
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- 1 Intro
- 2 Causes and Prevention of Falls
- 3 Bad things happen when you fall
- 4 Prevention, not treatment is better
- 5 Quality Measurement
- 6 Inpatient falls. difficult to prevent
- 7 Gait disorders: Common as we a Half of patients 85 yearst need cane or walker Workup of patients: History of balance trouble, falls, "dizziness" Exam: walking, tandem gait, Romberg, ortho BP, proprio…
- 8 Parkinson's disease Not all Parkinson's patients have tremor Gait is slow, with postural instability Shuffling, trouble arising and initiating gait Loss of associated movement: reduced arm swing, lea…
- 9 Frailty: frequent cause of falling Definition: "condition of being weak and delicate" Age is a risk factor, but age is not always predictive of frailty Age 65-74: 27% reported falls, age 85+: 37% rep…
- 10 Other neurologic causes Progressive supranuclear palsy-often fall on stairs (slow eye movement, voice and swallow trouble) Multiple system atrophy (Shy Drager): parkinsonian features with autonomic f…
- 11 Dizziness: multiple causes Dizziness is often a vague symptom, needs further evaluation Is it intermittent, triggered by movement (positional vertigo)? Is it just a feeling of lightheadedness? (Could…
- 12 How to prevent falls Exercise program Review medications: sleep meds, muscle relaxers, antidepressants, antipsychotics, etc. Vision testing yearly
- 13 Summary: History of falls is simple tool to detect risk of another fall (with injury) Frailty increases risk of faling with injury Medication, ortho blood pressures need to be checked Refer patients …
