How to Respond to Falls

Falls happen frequently in care settings, but your response determines the outcome. Quick, proper assessment prevents serious complications and saves lives.

Older adults in care homes face three times higher fall risk than community residents. One in four suffers serious injury requiring hospitalization. Your immediate actions make the critical difference.

Immediate Response Protocol

Step 1: Assess Safety First

• Check the environment for ongoing hazards

• Keep yourself safe - don't put yourself at risk

• Leave the person where they are unless in immediate danger

• Call for backup using emergency bells or colleagues

Step 2: Primary Assessment (ABC Check)

Airway, Breathing, Circulation

• Call 999 immediately if any ABC problems detected

• Check consciousness level - call 999 if unresponsive

• Monitor vital signs throughout assessment

Step 3: Head-to-Toe Examination

Before moving the person, check systematically:

Head and Neck

• Signs of head injury or bleeding

• Neck pain or restricted movement

• Level of consciousness changes

Limbs and Joints

• Bone deformity or unusual positioning

• Swelling, redness, or bruising

• Range of movement in all joints

• Pain response to gentle movement

Spine and Torso

• Back pain or tenderness

• Chest pain or breathing difficulties

• Abdominal pain or distension

When to Call 999

Call emergency services immediately for:

• ABC problems (airway, breathing, circulation)

• Loss of consciousness

• Suspected fractures or spinal injury

• Severe bleeding or head trauma

• Unwitnessed falls where person seems confused or injured

Contact GP or out-of-hours for:

• Non-urgent injuries requiring medical review

• Falls with unclear causes

• Signs of developing infection

• Minor injuries needing assessment

Movement Guidelines

DO NOT MOVE if:

• Suspected fracture - limb shortening, rotation, or deformity

• Head or spinal injury concerns

• Severe pain preventing normal movement

• Loss of consciousness at any point

Safe to Assist Movement if:

• Full range of motion in all limbs

• No pain during gentle movement checks

• Alert and responsive throughout assessment

• No signs of serious injury

Post-Fall Monitoring

Unwitnessed Falls or Head Impact

Neurological observations required for 24 hours:

• Every 30 minutes for first 2 hours

• Hourly for next 4 hours

• Every 2 hours for remaining 18 hours

• Report changes immediately to medical professionals

Witnessed Falls (No Head Impact)

Standard observations for 24 hours:

• Every 4 hours unless medical advice differs

• Monitor blood pressure, pulse, temperature, breathing

• Increase frequency if any concerns develop

Special Considerations for Dementia Patients

• Watch for behavior changes - increased agitation or confusion

• Monitor for listlessness or unusual responses

• Contact GP immediately for any distinct changes from baseline

Essential Documentation

Record Immediately:

• Exact time and location of fall

• Circumstances - witnessed or unwitnessed

• Assessment findings from head to toe

• Vital signs and consciousness level

• Actions taken and rationale for decisions

Ongoing Documentation:

• Treatment provided and patient response

• When 999 or GP contacted and outcomes

• Family notification time and response

• Changes to care plan and risk assessments

• Witness statements if available

Communication Requirements

Immediate Notifications:

• Emergency services if required

• GP or out-of-hours for medical advice

• Management of care facility

• Family members as per care plan

• All team members for care continuity

Professional Reporting:

• CQC notification for serious falls

• Safeguarding referral if appropriate

• Incident reporting through organizational systems

Fall Prevention Review

After Every Fall:

• Analyze contributing factors - medication, environment, health changes

• Update risk assessments immediately

• Implement new interventions to prevent recurrence

• Review mobility aids and environmental modifications

• Consider referrals to specialists if needed

Key Reminders

Patient Communication:

• Explain your actions throughout the assessment

• Provide constant reassurance to reduce anxiety

• Maintain dignity and privacy during examination

• Keep them still to prevent further injury

Professional Standards:

• Follow NICE guidance for head injury assessment

• Know your facility policies before incidents occur

• Ensure competent staff complete assessments

• Document thoroughly for legal protection

Remember: Not all falls are preventable, but proper response prevents complications and saves lives.

[Access Falls Prevention Resources]

Quick, systematic response to falls protects patients from serious complications and demonstrates professional competence.