When Should And Shouldn’t You Lift A Fallen Resident?

A question often asked in carehomes is when is it safe to lift an uninjured frequent faller using a lifting device like the Mangar Health Camel or Elk and when is it appropriate to call an ambulance.

To help answer that question West Midlands Ambulance Service commissioned the ISTUMBLE aid for internal use that is also incredibly helpful for people working in a care home environment…

I Stumble

Intense Pain

New pain since fall, including:

Headache, chest pain and abdominal pain

Consider both pain from injury caused by fall or medical causes

Suspected Collapse

Ask resident if, before their fall, they:

            – Tripped                   – Collapsed

            – Felt Dizzy                – Felt Nauseous

Trauma to Neck/Back/Head

New pain in neck/back/head following fall

New lump or dent in head with/without bleeding

Any new numbness/paralysis in any limbs

Unusual Behaviour

New confusion

Acting differently to normal self e.g. agitated, drowsy, quiet

Difficulty speaking e.g. slurred speech, words mixed up, marked stuttering

Marked Difficulty in Breathing/Chest Pain

Severe shortness of breath, not improved when anxiety is reduced

Unable to complete sentences

Blue/pale lips, blue fingertips, becoming lethargic or confused

Bleeding Freely

Free flowing, pumping or squirting blood from wound

Apply constant direct pressure to injury with clean dressing (elevate if possible)

Try to estimate blood loss (per mugful)

Loss of Consciousness

Knocked out

Drifting in and out of consciousness

Limited memory of events before, during or after fall

Unable to retain or recall information/repeating themselves

Evidence of Fracture

Obvious deformity e.g. shortened/rotated, bone visible, severe swelling

Reduced range of movement in affected area

Unusual movement around affected area

In all 999 cases remember to keep resident:  CALM, STILL & COMFORTABLE

If any bleeding is present, apply constant direct pressure with a clean dressing

Post Fall Assessment Summary – Resident Stays at Home

OBSERVE

Do NOT leave the resident unattended initially

Follow residents care plan

Look for new bruises, cuts, swelling etc., and record on a body map (page 4)

Check resident: Every 10 minutes for the first hour; Every hour for the next 2 hours; Every 2 hours until no longer concerned

If the resident falls asleep following the fall: Physically wake them and get them to talk to you

If there are ANY concerns speak to a health care professional or ring 111

MONITOR

Check and record any change in behaviour or symptoms e.g. nausea, confusion, drowsiness and agitation, for at least 2 days

If the resident displays any of the above symptoms contact their GP

Record in Care Plan and/or notes

REPORT

Complete a Safeguarding Alert Form if:

The resident has an unexplained fall that requires medical attention

There appears to have been a failure to follow the support plan or implement interventions to minimise or flag risk

Inform the resident’s relative(s) or next of kin

Supporting Information

Possible Signs of Fracture:

Shortening of limbs

Restricted limb movement

Inability to weight bear

Pain on applying pressure

Deformity

Head Injury Advice:

Make sure the resident:

Stays within easy reach of help for the first 48 hours

Has plenty of rest and avoids stressful situations

Avoids taking any alcohol or drugs, sedatives or tranquillizers, unless they are advised/given by a Doctor

If they develop ANY of the following call 999 immediately:

A change in consciousness or experience confusion

Fluid leak from their ear or nose

Drowsiness when they would normally be awake

New problems with understanding or speaking, loss of balance, problems walking or weakness in one, or both arms or legs

New problems with their eyesight shortly after the injury

A worsening headache

Vomiting or seizures