Welsh Ambulance Services NHS Trust Integrated Falls Pathway

Integrated Falls Pathway Older people who fall account for approximately 10% of all 999 calls to the Welsh Ambulance Services NHS Trust (WAST) 45% are managed at home by the attending ambulance crew without a recognised referral pathway Many of those transported to A&E are subsequently discharged without further intervention There is a risk that of those patients managed at home, a high percentage of patients potentially generate secondary 999 calls for subsequent falls

Integrated Falls Pathway Working in collaboration with our healthcare partners, an Integrated Care Pathway for Older people who fall has been devised that will enable WAST Paramedics to refer patients with capacity to a Falls Assessment Team for further follow-up, rather than conveying them to an A&E department

The Referral Process Has the Patient fallen more than 1 metre or 5 steps

Does the patient have a positive Face, Arm, Speech Test (FAST) The Referral Process Does the patient have a positive Face, Arm, Speech Test (FAST)

Has there been any altered level of consciousness The Referral Process Has there been any altered level of consciousness

Has the patient suffered any amnesia before or after the fall The Referral Process Has the patient suffered any amnesia before or after the fall

Has the patient vomited since the fall The Referral Process Has the patient vomited since the fall

Does the patient have any injuries that require treatment The Referral Process Does the patient have any injuries that require treatment

Is there any evidence of limb deformity The Referral Process Is there any evidence of limb deformity

What Happens When The Paramedic Gets There? The crew make an assessment of the patient’s condition. If none of the ‘Red Flag’ criteria are present, the crew make a ‘Fall Referral’ The patient is asked to sign the form? A copy of both the Patient Clinical Record (PCR), and Fall Referral form is left with the patient Information is passed to the Falls Team via Ambulance control

Where in Wales? Anglesey Conwy & Denbighshire Flintshire Wrexham Powys Carmarthenshire Neath Port Talbot Swansea Cardiff & Vale

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