Frequent 911 fall calls in older adults: opportunity for injury prevention strategies
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OBJECTIVES: To evaluate the utility of monitoring emergency medical services (EMS) call patterns to identify older adults who may benefit from targeted fall prevention and medical monitoring strategies. DESIGN: Retrospective chart review of EMS fall-related care. The HealthEMS database for the community surveyed was queried from January 1, 2007, through December 31, 2016. Fall-related calls for individuals aged 60 and older were identified and used to determine which individuals had subsequent fall calls and needed transport to the hospital over the study time period. SETTING: Medium-sized suburban community. PARTICIPANTS: Community-dwelling adults aged 60 and older with fall-related calls. MEASUREMENTS: Descriptive EMS cell data. RESULTS: Over the 10-year period, 37,324 EMS call data were recorded, with 11% (N=4,084) identified as fall-related calls that occurred for individuals aged 60 and older. Twenty-nine percent (n=685) of individuals who called for a fall called at least one more time within the study period. Time between calls substantially decreased the more frequently an individual called (p<.001). Fifteen percent (n=107) of repeat callers called 5 or more times for falls, and these individuals were transported to the hospital only 21% of the time (vs 75% of first-time callers, p <.001). CONCLUSION: Certain older individuals are at risk of having multiple fall-related calls to EMS over short periods of time, sometimes within hours of previous calls. In our current healthcare system, no significant intervention or follow-up is offered or available by emergency first response teams to prevent subsequent falls. This study demonstrates the need for a paradigm change in our healthcare system that helps reduce resource utilization for the first responder community for fall-related calls in older adults and re-directs those resources to implement nationwide fall-prevention strategies to decrease fall related disability and death.
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