Paramedics to focus on preventing falls at home

Ambulance Research acting director Dr Sandy Muecke said falls constituted the most common medical emergency attended by paramedics.

“Of approximately 825,000 emergency responses annually, almost 74,000 calls involve falls,”Dr Muecke said. “Sixty per cent of those involve people aged over 65.”

She said responses to cases involving falls were most common for patients aged 80 years or older, most of whom had fallen from a standing height.

“For older people, two-thirds of falls happen in the home, followed by those occurring in public places or residential aged-care facilities.”

NSW Ambulance has been proactive in its approach to treating falls patients, particularly those aged 65 years an over. This message was highlighted during April Falls Month, which is held annually to promote falls prevention messages.

Paramedics are trained to assist senior patients who have fallen but do not require emergency care.

Extended Care Paramedic (ECP) and clinical development educator Jeff Andrew said once patients were assessed as not requiring ambulance transport, they were reviewed in their home for future risk of falls.

“We conduct a physical examination - including vision and mobility tests, together with a full medical history and social history to determine whether they have carers,” ECP Andrew said.

“In some instances, the patients are then referred on to allied health professionals, such as occupational therapists who come in and assess the home for safety changes.”

Where the fall relates to an underlying health condition, recommendations and referrals are made for specialist treatment.

ECP Andrew said a future aim would be to conduct falls assessments on all patients aged 65 years and over, irrespective of the reason why paramedics were called to the home. 

“Our aim is proactivity, identifying the risk before a fall occurs,” he said.

NSW Ambulance is also involved in several research and clinical development projects, aimed at ensuring patients with injuries from falls receive high-quality, pre-hospital care.

Paramedics from six ambulance stations in Sydney’s east are taking part in a clinical trial of a new model of preventative care for older patients who have fallen, but who are not transported to hospital.

NSW Ambulance research assistant Paul Simpson said the three-year, NSW government funded trial conducted in collaboration with Neuroscience Research Australia, involved the rapid referral of patients to a falls prevention team who attended the patient’s home and assessed their risk of falling again.

“The aim of the study is to determine the effectiveness of a new, specific falls prevention model of care in reducing future falls and improving patient health outcomes,” Mr Simpson said.

“Eligible, elderly patients who have fallen are engaged in a six-month intervention

program during which time such things as medications, visual acuity, gait and balance, and muscle strength are assessed.”

Risk factors for falls include poor balance and eyesight, slippery surfaces and uneven ground.

Research shows the risk can be substantially reduced with regular, moderate exercise and by incorporating balance and leg strength exercises into the daily routine.

Tips for preventing falls at home

o Securing mats and rugs and ensuring they have slip resistant backing

o Slip resistant mats in the shower recess and bath

o Non-skid treads or paint on steps

o Grab rails for the shower or bath

o Handrails on at least one side of stairwells

o Sensor lights in entrances, passageways and on stairs

o Keeping regularly used items within easy reach

o Keeping all electrical and telephone cords away from walkways.

o Beds should be at a height that makes it easy to get in and out. Get out of bed slowly - sit up first before you stand up.

Source: www.activeandhealthy.nsw.gov