Emergency Medicine

Further Reading

General Medical Emergencies 121

(viii) Balance disorder:

(a) inner ear disease

(b) impaired proprioception.

2 Result of the fall:
(i) Fracture:
(a) Colles’
(b) neck of femur or pelvis
(c) neck of humerus
(d) ribs
(e) skull.
(ii) Hypothermia.
(iii) Hypostatic pneumonia.
(iv) Pressure sore, rhabdomyolysis.
(v) Fear, loss of confidence and independence, loss of mobility.

3 All falls in the elderly, particularly if recurrent, must be diagnosed and
managed correctly, otherwise ultimately a fatal outcome will occur.

MANAGEMENT

1 Refer the patient to the medical or geriatric team for admission if acute care
is needed, or if there is any doubt about their ability to cope at home.

2 Otherwise, refer to outpatients, physiotherapy, occupational therapy or
social services and liaise closely with the GP.

FURTHER READING

American Heart Association (2010) Part 10: Acute coronary syndromes: 2010
American Heart Association guidelines for cardiopulmonary resuscitation and
emergency cardiovascular care. Circulation 122 : S787–817.

American Heart Association (2010) Part 11: Adult stroke: 2010 American Heart
Association guidelines for cardiopulmonary resuscitation and emergency
cardiovascular care. Circulation 122 : S818–28.

British Infection Association. http://www.britishinfection.org/drupal/ (meningitis
and meninogococcaemia).

British Society of Gastroenterology. http://www.bsg.org.uk/ (gastrointestinal
bleeding).

British Thoracic Society. http://www.brit-thoracic.org.uk/ (pulmonary embolus,
pneumonia, chronic obstructive pulmonary disease, pneumothorax).

Diabetes UK. http://www.diabetes.org.uk/ (diabetic ketoacidosis).