Falls in the prehospital environment

Falls contribute significantly to the workload of ambulance paramedics. Falls can range dramatically in severity, with no injuries to considerable morbidity and mortality. The objective of this study was to identify the incidence of falls and the outcome from an ambulance perspective. Method: A literature search was conducted using electronic databases: Ovid Medline, EMBASE and Scopus. These databases were searched from their beginning to the end of July 2010. All references from the articles retrieved were also reviewed. Articles were included if they reported on falls attended by ambulance crews, or fall related injuries in the prehospital environment. Results: A total of 405 articles were identified with 21 articles meeting the inclusion criteria. There was one randomized trial, seven retrospective studies, two prospective studies, and one combined prospective retrospective study. Of the remaining studies, one was an epidemiological study, one a literature review, one clinical observation study, one pilot study and one case study. Five articles were excluded due to a lack of prehospital specific data. None of the studies reported a definition of a fall. Conclusion: Despite the relative frequency of falls, there is a substantial gap in the prehospital literature covering the implications for paramedic practice.

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