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Falls in the prehospital environment

04 April 2011
Other
02 April 2011
Volume 3 · Issue 5

Abstract

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.

Falls are seen internationally as a major health issue, with increasing research in recent decades attributed to falls prevention programmes (Close et al, 2002; Weiss et al, 2003; Snooks et al, 2010). These programmes often focus on the elderly and are community based, however, some have prehospital personnel involvement. Fleming et al (2008) suggests that many people fall more than once, further strengthening the current resolve towards preventative programmes.

Ambulance paramedic workload as the result of falls could be up to 2 days per month in the UK (Newton et al, 2006). Snooks et al (2006) reported that paramedics respond to 300 000—400 000 calls for elderly falls annually. This results in 8% of total paramedic workload in the UK, however, 40% of these patients were not conveyed to hospital post fall. Though Snooks et al (2006) believe this figure should be closer to 600 000 per year, equating to approximately 18% of paramedic workload. Of the calls made in the London geographical area, approximately 50% were made outside of standard business hours.

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Falls
Out of hospital
Paramedics
Prehospital