A fall can cause injuries ranging from minor bruises to life-threatening trauma. Falls represent a significant public health concern, especially for older adults, often leading to serious injury and hospitalization. Knowing the appropriate first steps immediately following a fall is crucial for a positive outcome. A calm, structured approach ensures that immediate dangers are addressed and the person receives the appropriate medical attention without delay. This guide provides actionable steps for managing the moments right after a fall, from scene safety to recognizing when emergency services are necessary.
Immediate Safety and Initial Assessment
The first action upon discovering a person who has fallen is to assess the environment for hazards that could endanger you or the person. Look for risks like spilled liquids, broken glass, electrical cords, or unstable objects before approaching. Once the scene is safe, determine their responsiveness by gently asking if they are alright or tapping their shoulder. If they are conscious, proceed with a detailed assessment, but if they are unconscious or unresponsive, call 911 immediately.
Do not attempt to move the person unless they are in immediate danger, such as near traffic or a fire hazard, because moving them could worsen an existing spinal or neck injury. If the person is unresponsive, perform a primary survey to check their airway, breathing, and circulation (ABC). Ensure the airway is open, check for normal breathing, and look for severe bleeding that requires direct pressure. This rapid assessment manages urgent, life-threatening issues before help arrives.
Recognizing Critical Signs Requiring Emergency Services
Certain signs and symptoms following a fall require an immediate call to 911 for professional medical transport. Any loss of consciousness, even if brief, is a red flag for a serious head injury and requires emergency evaluation. Severe pain in the head, neck, or back should also trigger an emergency call, especially if the person is unable to move or reports numbness or tingling in their limbs, suggesting a spinal cord injury.
Emergency services are necessary for severe bleeding that cannot be stopped by direct pressure or if you observe an obvious bone fracture. Other critical signs include confusion, slurred speech, difficulty waking up, or repeated vomiting, which can indicate a brain bleed or internal injury. Allow trained paramedics to stabilize and transport the person, as they have the equipment to do so without causing further injury.
Managing Common Minor Injuries
If the initial assessment suggests only minor injuries, proceed with basic first aid care. For minor cuts and abrasions, clean the area gently with soap and water to prevent infection, and apply a clean bandage. Bruises, sprains, or strains can often be managed using the R.I.C.E. protocol: Rest, Ice, Compression, and Elevation.
Rest the affected area for 24 to 48 hours to allow soft tissues to begin healing. Apply ice for 15 to 20 minutes every few hours during the first 48 hours, wrapping it in a cloth to protect the skin. Compression with an elastic bandage limits swelling, and elevating the injured limb above the heart level uses gravity to reduce fluid accumulation. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also be used to manage discomfort, but always follow dosage instructions.
Monitoring for Delayed Symptoms
Even if the person appears fine immediately after the fall, monitoring for delayed symptoms is necessary for the next 24 to 72 hours. Serious conditions, like a concussion or a slow internal bleed, may not show signs right away. Delayed concussion symptoms can emerge hours or days later and include a persistent or worsening headache, dizziness, and persistent nausea or vomiting.
Watch for subtle changes in behavior or mental status, such as increased confusion, irritability, or excessive sleepiness. Other delayed red flags include problems with memory or concentration, sensitivity to light or sound, vision changes, or difficulty with coordination. If any of these delayed symptoms develop, seek medical attention promptly, as a medical professional needs to rule out complications like a subdural hematoma.