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FOCUSED SHIFT VIEW

Falls & Geriatric Trauma

A fall may be injury, syncope, medication harm, infection, or a sentinel loss of function.

Open full pathway
Educational first-pass aid. Reassess the patient, confirm doses and use local protocols.

1 · First minutes

  1. Treat injury and ask why the fall happened: trip, collapse, dizziness, seizure, stroke, medication effect, or infection.
  2. Lower the threshold for head, cervical-spine, pelvic, and hip evaluation when examination or history is unreliable.
  3. Assess mobility, cognition, supports, medications, and ability to return safely before discharge.

2 · Escalate now if

  • Anticoagulation with head impact or neurologic change
  • Inability to bear weight, severe hip/groin or neck pain
  • Unwitnessed collapse, exertional fall, or prodromal palpitations/chest pain
  • New delirium, hypotension, fever, or prolonged time on floor
  • Unsafe home environment or no reliable observation

3 · Immediate workup

  • ECG, glucose, targeted labs; CT head/c-spine per risk and local pathway
  • X-ray hip/pelvis; CT/MRI for persistent suspicion with negative radiographs

4 · Don’t miss

  • Intracranial hemorrhage
    Head strike, anticoagulation, altered baseline, vomiting, or new neurologic symptom warrants a low imaging threshold and local pathway.
  • Hip/pelvic fracture
    Persistent hip/groin pain or inability to bear weight can be occult despite normal initial radiographs.
  • Syncope/arrhythmia/ACS/stroke as precipitant
    An unexplained fall may be transient loss of consciousness or neurologic event.

5 · Disposition lane

Admit / observation

Occult-injury concern, functional decline, delirium, medical precipitant, or unsafe disposition.

Trauma / neurology / cardiology pathway

Hemorrhage, fracture, syncope/arrhythmia, stroke, or significant trauma.