Lecture 3: Falls, Fractures & Trauma

Anne is a 78-year-old, previously independent but increasing fear of falling, who suffers a fall in the middle of the night on her way to the toilet and breaks her right hip. She also suffers a chest injury manifest by a few broken ribs and a haemothorax. After initial management by paramedics and in the ED, she is admitted to the orthopaedic ward and then discharged to rehab.

Think of the aetiology of fragility fractures and the typical person who suffers a fracture of the femoral neck.

Consider the mechanism of trauma in older people and how the approach needs to be modified to account for frailty.

Q1: How would you establish why she fell?

Q2: What injuries did she suffer from the fall?

Q3: How would you stop her from falling again?

VIDEOS

#LeicGEM educators Prof. Simon Conroy & Dr. Jay Banerjee discuss the management of a patient on the Emergency Frailty Unit (EFU) who suffered a fall at home.

FURTHER READING

• Falls in Older People: Assessing Risk and Prevention [NICE Guidance]

• Evaluation and Management of Geriatric Trauma [Eastern Association for the Surgery of Trauma]

• Geriatric Trauma [EMERGPA]

• Hip Fracture Overview [NICE Guidance]

• The National Audit of Falls and Bone Health [Royal College of Physicians]

• Stealth Trauma (SimBlog) [#EM3]

• Stealth Trauma (LightningLearning) [#EM3]

QUIZZES

• Falls [University of Nottingham]