Number 2 – Don’t fall
Okay, this may not be an exciting category, but falls are a huge problem, especially for the elderly. Falls are the most likely cause of injury for those over age 65. Hang glider accidents are a close second. Kidding! If you know anyone who is unsteady on their feet, they should have a home safety evaluation right away to look for all the possible places they could fall down. Stairs, throw rugs are notorious.
Now if you think just because you’re not a senior, and pretty healthy, that you are immune to the plague of falls sweeping our nation, think again! We see healthy people all day long that have fallen off decks, down stairs, jumping out of trucks, climbing fences, off ladders, etc. I had a firefighter fall off a ladder from 15 feet up because he had the feet set on a smooth, slippery concrete, and no-one was holding on for him. Dumb! If he was saving a life at the time, I could forgive it, but he was just cleaning out rain gutters.
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Falling can be deadly to an elderly person. My mother had a fall when she was 83 and one year later died. She didn’t break anything, but spending time in bed in pain took her strength away and she never got it back. Now my mother-in-law at age 83 had a bad fall. Nothing broken but lots of pain and she can’t walk. She’s in Greece and now in a “convalensence hospital”. I’m keeping my fingers crossed. Myself, I’ve had a couple of bad falls and with one hip replacement already I know I need to be more careful. My last fall gave me a broken bone in my foot and I haven’t been able to walk pain free since…ciao
We teachers have a lot of falls as well. We tend to trip over backpacks, notebooks, jackets, small children- or off of chairs and tables we use to hang stuff on the walls. Seriously, what are we thinking! In a classroom of 31 kids, it’s a daily occurence! Crazy! At least we get summers off to recuperate.
I have EDS Hypermobility, and I fall a lot. I don’t usually get injured because I fall, I usually fall because I’m injured. Dislocating or subluxing a hip, knee or ankle while walking usually makes me fall. Occasionally the act of landing pops my errant joint back into place.
Just to give you a different view of falling…
And if you fall, EMS is still unlikely to give you anything for pain. The move to the ambulance, the ride to the hospital, and the move to the hospital bed will give you a new appreciation of what pain means.
Why don’t we treat pain? Protocols prevent, or discourage, effective pain management.
Is there any good reason to withhold treatment? No.
Some medics are lazy, but the biggest problem is the obstacles created by requirements to call for permission to treat patients. The permission should already be in the protocol.
One huge study (over 2,000 patients treated with fentanyl on standing orders) makes it clear that aggressive treatment with fentanyl entirely on standing orders is safe and effective.
Safety and effectiveness of fentanyl administration for prehospital pain management.
Kanowitz A, Dunn TM, Kanowitz EM, Dunn WW, Vanbuskirk K.
Prehosp Emerg Care. 2006 Jan-Mar;10(1):1-7.
PMID: 16418084 [PubMed - indexed for MEDLINE]