After a fall in the hospital
Definition
Falls can be a serious problem in the hospital. Factors that increase the risk of falls include:
- Poor lighting
- Slippery floors
- Equipment in rooms and hallways that gets in the way
- Being weak or confused from illness or surgery
- Being in new surroundings
- A history of falls
Hospital staff often do not see patients fall. But falls require attention right away to lessen the risk of injury.
Alternative Names
Hospital safety - falls; Patient safety - falls
When the Patient Falls
If you are with a patient when they begin to fall:
- Use your body to break the fall.
- Protect your own back by keeping your feet wide apart and your knees bent.
- Make sure the patient's head does not hit the floor or any other surface.
After the Fall
Stay with the patient and call for help.
- Check the patient's breathing, pulse, and blood pressure. If the patient is unconscious, not breathing, or does not have a pulse, call a hospital emergency code and start CPR.
- Check for injury, such as cuts, scrapes, bruises, and broken bones.
- If you were not there when the patient fell, ask the patient or someone who saw the fall what happened.
If the patient is confused, shaking, or shows signs of weakness, pain, or dizziness:
- Stay with the patient. Provide blankets for comfort until medical staff arrives.
- Do not raise the patient's head if they may have a neck or back injury. Wait for medical staff to check for a spinal injury.
Once medical staff decides the patient can be moved, you need to choose the best way.
- If the patient is not hurt or injured and does not appear ill, have another staff member help you. Both of you should help the patient into a wheelchair or into bed. Do not help the patient on your own.
- If the patient cannot support most of their own body weight, you may need to use a backboard or a lift.
Watch the patient closely after the fall. You may need to check the patient's alertness, blood pressure and pulse, and possibly blood sugar.
Document the fall according to your hospital's policies.
References
Adams GA, Forrester JA, Rosenberg GM, Bresnick SD. Falls. In: Adams GA, Forrester JA, Rosenberg GM, Bresnick SD, eds. On Call Surgery. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 10.
Andrews J. Optimizing the built environment for frail older adults. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 132.
Quinn TJ. Ageing and disease. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 34.
Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
