The prehospital management of ambulance-attended adults who fell: A scoping review

Paige Marie Watkins; Stacey Masters; Anne-Marie Hill; Hideo Tohira; Deon Brink; Judith Finn; Peter Buzzacott

doi:10.1016/j.auec.2022.07.006

The prehospital management of ambulance-attended adults who fell: A scoping review

Australas Emerg Care. 2023 Mar;26(1):45-53. doi: 10.1016/j.auec.2022.07.006. Epub 2022 Jul 29.

Authors

Paige Marie Watkins¹, Stacey Masters², Anne-Marie Hill³, Hideo Tohira⁴, Deon Brink⁵, Judith Finn⁶, Peter Buzzacott²

Affiliations

¹ Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, WA, Australia. Electronic address: paige.watkins@student.curtin.edu.au.
² Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, WA, Australia.
³ School of Allied Health, University of Western Australia, Crawley, WA, Australia.
⁴ Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, WA, Australia; Emergency Medicine, Medical School, the University of Western Australia, Crawley, WA, Australia.
⁵ Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, WA, Australia; St John Western Australia ambulance service, Belmont, WA, Australia.
⁶ Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, WA, Australia; Emergency Medicine, Medical School, the University of Western Australia, Crawley, WA, Australia; St John Western Australia ambulance service, Belmont, WA, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia.

PMID: 35909044
DOI: 10.1016/j.auec.2022.07.006

Abstract

Background: The ageing population is requiring more ambulance attendances for falls. This scoping review aimed to map and synthesise the evidence for the prehospital management of Emergency Medical Services (EMS) attended adult patients who fall.

Methods: The Joanna Briggs Institute methods for scoping reviews were used. Six databases were searched (Medline, Scopus, CINAHL, Cochrane, EMBASE, ProQuest), 1st August 2021. Included sources reported: ambulance attended (context), adults who fell (population), injuries, interventions or disposition data (concept). Data were narratively synthesised.

Results: One-hundred and fifteen research sources met the inclusion criteria. Detailed information describing prehospital delivered EMS interventions, transport decisions and alternative care pathways was limited. Overall, adults< 65 years were less likely than older adults to be attended repeatedly and/or not transported. Being male, falling from height and sustaining severe injuries were associated with transport to major trauma centres. Older females, falling from standing/low height with minor injuries were less likely to be transported to major trauma centres.

Conclusion: The relationship between patient characteristics, falls and resulting injuries were well described in the literature. Other evidence about EMS management in prehospital settings was limited. Further research regarding prehospital interventions, transport decisions and alternative care pathways in the prehospital setting is recommended.

Keywords: EMS; Emergency Medical Technician; Fall; Injury; Paramedic.

Publication types

Review

MeSH terms

Aged
Ambulances*
Emergency Medical Services*
Female
Humans
Male
Trauma Centers