A sudden fall can be a jarring and frightening event. Knowing the correct immediate response can significantly reduce the risk of secondary injuries and determine the speed and success of recovery. Taking quick, measured action is important for assessing the situation and ensuring the safety of everyone present.
Scene Safety and Initial Assessment
The very first action must be to check the immediate surroundings for any ongoing hazards that could threaten the fallen person or the responder. This involves a rapid survey for dangers like spilled liquids, live wires, or unstable objects that may have caused the fall. If the area is unsafe, the person should not be approached until the environment is secured, or professional help is called to manage the hazard.
Once the scene is deemed safe, approach the individual calmly and establish communication to determine their level of consciousness. Ask simple questions like, “Are you okay?” or “What happened?” to check for responsiveness. If the person does not respond to verbal cues, gently tap or shake them to elicit a reaction.
If the person remains unresponsive, the focus immediately shifts to checking their basic life support needs: airway and breathing. Look, listen, and feel for normal breathing for no more than 10 seconds. If they are not breathing, or are only gasping, emergency medical services must be activated immediately, and cardiopulmonary resuscitation (CPR) should begin if the responder is trained.
Recognizing and Managing Serious Injuries
If the person is conscious, the next step is a focused check for specific signs that indicate a severe injury requiring immediate professional attention. Any indication of a spinal or neck injury, such as severe pain in the neck or back, should prevent any attempt to move the person. The individual must be kept as still as possible, discouraging them from twisting or moving their head.
Uncontrolled, severe bleeding demands immediate action and a call to emergency services. Direct, firm pressure should be applied to the wound using a clean pad or cloth to help manage the blood loss while waiting for paramedics. Signs of a suspected fracture, such as an obvious deformity, an open wound with bone protrusion, or an inability to bear weight, also necessitate an emergency call.
Neurological changes are concerning following a fall, even if the head impact was not witnessed. Symptoms like confusion, severe dizziness, slurred speech, or persistent vomiting may signal a traumatic brain injury. A decline in the level of consciousness or any numbness and tingling in the extremities should also prompt an immediate call to 911.
When a serious injury is suspected, the primary goal is to stabilize the person and keep them comfortable until medical personnel arrive. If there is a potential spinal injury, the person should not be moved unless they are in immediate danger. Cover the person with a blanket or coat to maintain body temperature, as shock can cause a drop in core temperature.
Assisting the Individual After a Minor Fall
If the fallen person is fully alert, cooperative, and reports no severe pain, they may be assisted in rising, but this must be done with caution and without lifting them directly. First, ask the person where they feel pain, if any, and visually check for signs of injury like swelling or bruising. If they report sharp pain, especially in the hips or back, or if they cannot move a limb, assistance should stop, and medical help should be sought.
Assuming no serious injury is found, guide the person to roll onto their side, which is a less strenuous position. Encourage them to perform the movement themselves, with the responder offering only gentle guidance at the shoulder and hip. The person should then be helped into a hands-and-knees position.
Next, a sturdy, non-wheeled chair or piece of furniture should be placed directly in front of the kneeling person. The individual should place their hands on the seat of the chair to support their upper body weight. They can then be encouraged to bring their stronger leg forward, placing the foot flat on the floor, moving into a high-kneeling position.
The final part of the maneuver involves placing a second sturdy chair behind the person, or using the first chair to push up. The person uses their arms and legs to push themselves up to a standing position, or to pivot and sit directly onto the second chair. The helper should stand close behind them, using a wide stance and keeping their back straight, ready to support the person’s belt line or hips to maintain balance without lifting.
Follow-up and Documentation
Even when a person is helped up successfully and appears unharmed, a medical follow-up is important, as some injuries, such as internal bruising or a slow-developing head injury, may not be immediately apparent. Symptoms like persistent headaches, new back pain, or increasing confusion can emerge hours or even days after the incident. It is advisable to contact the person’s healthcare provider to inform them of the fall.
Documentation of the event is a useful preventative measure. This documentation should capture the time and location of the fall, what the person was doing immediately beforehand, and any environmental factors that may have contributed, such as poor lighting or loose rugs. Recording these details helps in identifying and addressing the underlying causes of the fall to prevent recurrence.
Monitoring the individual for the following 24 to 72 hours is a recommended precaution, particularly for changes in their behavior, mobility, or vital signs. This period allows for the detection of delayed symptoms which might indicate a more serious injury that was initially masked by adrenaline or shock. The information gathered should be used to revise care plans or make necessary environmental adjustments.