Pathophysiology

Relevant patient pathology may be found which can pertain to have been causative, or as a consequence of, the fall. Whilst a large proportion of falls may be deemed to be ‘mechanical’ in nature, in reality it is likely there are detectable disease processes or social factors that might have made the patient susceptible to falling by impairing their consciousness (eg. causes of syncope), ability to balance (eg. causes of vertigo) or safety at home (have they become increasingly frail at home with increased care needs that are unmet?).

Patients who have had a ‘long lie’ on the floor (>1 hour) after having fallen are at high risk of complications such as dehydration, pressure sores, pneumonia, hypothermia and rhabdomyolysis.

These considerations should be taken into account in conjunction with having to assess and manage the harm caused by the fall which can include head injuries, limb injuries and/or fractures (eg. fractured neck of femur).

Learning Bite

Complications of falls are varied and can range from debilitating to potentially life threatening. The consequences of each episode should not blind the clinician to seeking out causative factors for the fall.