ED patient falls and resulting injuries

Abstract

Introduction: Patient falls are the most common adverse events reported in hospitals. There is a growing body of literature on inpatient falls but a lack of data on ED falls. We applied the Hendrich II Fall Risk Model to patients who fell during their ED stays and provided a description of the patients and their injuries.

Methods: We retrospectively reviewed the medical records of all patients who fell in the emergency department during a 2-year period. We collected the 8 assessment parameters for high-risk fall identification in the Hendrich II Fall Risk Model. We also collected subject characteristics, circumstances surrounding the falls, fall-related injuries, and ED disposition.

Results: Fifty-seven falls were recorded, representing a rate of 0.288 falls per 1000 patient visits. The average age was 50 years, and a median of 48. 67% were men. Twenty-one subjects had a Hendrich II Model score of 5 of greater, which represents a sensitivity of 37.5%. Eleven subjects (19.6%) were intoxicated with alcohol. Eleven subjects (19.6%) received a potentially sedating medication prior to the fall. Thirty-six subjects (64.3%) fell in their ED rooms. Six subjects (10.7%) fell in the restroom. Three falls (5.4%) resulted in lacerations and 2 falls (3.6%) resulted in hematomas.

Discussion: The Hendrich II Fall Risk Model may not reliably identify patients at high risk of falling in the ED setting. It may be necessary to develop an emergency department-specific fall model considering additional factors, such as intoxication and receipt of potentially sedating medications.