Patient Fall Prevention

Even though therapies exist, many seniors are not evaluated or treated for osteoporosis, including those who have had a fracture. In these patients, fall prevention plus BMD optimization is necessary to optimally reduce fracture risk. Functional status impairment is also an important contributor to fractures in seniors. ... 

Atonic seizures are those in which the patient has sudden loss of postural tone. If standing, the patient falls suddenly to the floor and may be injured. If seated, the head and torso may suddenly drop forward. Although most often seen in children, this seizure type is not unusual in adults. Many patients with atonic seizures wear helmets to prevent head injury. 

What other measures would patients with this condition need to take, including falls prevention ... 

The need and demand for pharmaceutical care can be expected to intensify as sociefy realizes fhaf a significanf proportion of drug-related morbidity and mortality is preventable. In 1995, it was widely disseminated that drug-related morbidity and mortality cost the U.S. 76 billion annually, and more recent estimates place this figure close to 200 billion annually. Furthermore, 44,000 to 98,000 institutionalized patients fall victim to drug-relafed mortality." It is... 

This is a case study of a patient who might be seen by a physiotherapist working in a Falls Prevention Service. This is quite a complicated case and you may need to refer to previous chapters and the BNF. 

Many fall prevention-related recommendations in the area of patient acute... 

Review facility historical accident and injury records to assist in identifying slip, trip, and fall hazards. Establish written housekeeping procedures and reqnire everyone including patient care staff to immediately report spills and other floor hazards. Incorporate slip, trip, and fall prevention education into recurring safety training. Conduct awareness campaigns to educate employees about the risk of slips, trips, and falls. Provide feedback on the actions taken to prevent slip, trip, and fall injuries. 

The range of motion of the knee joint should be tested actively and passively. The patient should be instructed to flex and extend the knee while seated and, from the standing position, to squat and arise. The latter tests muscle strength as well as active range of motion. The physician should hold the hands of older patients to prevent them from falling. 

Administration of tiiese drugs may result in varying degrees of drowsiness. To prevent accidental falls and other injuries, die nurse assists the patient who is allowed out of bed with ambulatory activities. If extreme drowsiness is noted, the nurse instructs the patient to remain in bed and provides a call light for assistance... 

Efforts to decrease the risk of falling include balance training, muscle strengthening, removal of hazards in the home, installation of fall-reduction measures such as handrails in the home, and discontinuation of predisposing medications.1,2,10 Additionally, the use of hip protectors is an effective way to prevent hip fractures, although adherence to this measure is poor, and some patients may not be amenable to wearing them at all.10... 

Platelet transfusions are used to prevent hemorrhage. Patients with uncomplicated thrombocytopenia can be transfused when the platelet count falls below 10,000/pL (10 x 109/L). Patients who are either highly febrile or actively bleeding may require transfusions at higher levels. Red blood cell transfusions generally are not necessary for a hemoglobin concentration greater than 8 g/dL (80 g/L, 4.96 mmol/L). 

The moral hazard associated with health insurance is twofold that which occurs ex ante, which consists in failing to prevent health problems because he or she knows that he or she is protected in the event of falling ill, and expost moral hazard, which is what occurs when rational consumers consume quantities that are greater than the optimum once they fall ill, because the marginal cost for the co-insured patient is lower than the marginal cost of production. 

It therefore seems likely that the anti-hypertensive action of the -blocking drugs is in some way associated with the decline in peripheral resistance which had initially been elevated as a response to a reduction in cardiac output. The precise mechanism responsible for the fall in total peripheral resistance is as yet unknown. We do know however that the majority of untreated hypertensives show an excessive sympathetic response to stimulae such as stress and exercise. It has been clearly shown that the substantial rise in blood pressure experienced by hypertensive patients following exercise is prevented by 8-blocking drugs (20). It could be therefore that it is simply the blockade of surges in cardiac output and blood pressure which leads to a relaxation of the vascular bed and the... 

Blood glucose levels in patients with von Gierke disease fall precipitously upon fasting, such as occurs overnight during sleep, so treatment is to eat meals often to prevent hypoglycemic coma. 

It is clear that legislation alone will not prevent substance abuse. Education is an essential complement and all health care workers should play their r51e in individual or group education. They should also be good role models. Health professionals have easy access to drugs and they must be very careful that they do not fall temptation to the misuse of psychoactive products to alleviate their mood, prevent tiredness, and to combat other stress related symptoms. They should manage their patients along the same lines. 

The risk of adverse reactions is low, and includes mainly vaso-vagal reactions, which can partly be prevented by the patient lying down in connection with the application. The vaso-vagal reaction is characterized by a fall in blood pressure, bradycardia, pallor and, rarely, loss of consciousness and convulsions. Infiltration of larger amounts of anaesthetics, e.g. in a fracture hematoma, increases the risk of systemic toxic reactions with paraesthesias, metal taste and visual disturbances. The infiltration should be stopped when there are such symptoms, which could precede the more serious reactions (loss of consciousness and convulsions). 

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