Building on the RCP FallSafe care bundles: Is observation and review the key to reducing inpatient falls? The Northumbria experience 2013-2020.

The Royal College of Physicians (RCP) FallSafe care bundles are the recommended foundation for inpatient falls prevention in the UK. Yet there is a paucity of data to support its widespread use and the reductions in falls demonstrated in the original pilot and in subsequent small studies have not yet been reproduced in larger patient groups. Northumbria Healthcare NHS Foundation Trust (NHCFT) has seen a significant reduction in falls, falls per 1,000 bed days and harm from falls between 2013-2020 when combining the RCP FallSafe care bundles with a supportive observation policy (SOP) related to falls prevention.

The Royal College of Physicians' Fallsafe care bundles applied trustwide: the Northumbria experience 2013.

The Royal College of Physicians' FallSafe care bundles constitute measures of good practice, some of which are recommended for all patients, some are additional measures for older and more vulnerable patients admitted to hospital, and there is another bundle for after an inpatient fall, to reduce the number of inpatient falls. In 2013 a dedicated healthcare assistant, trained by the falls team, started a monthly spot audit looking at preventative measures, on all inpatients on every ward of the trust. Monthly results were fed back to the ward managers, ward falls liaison nurses, doctors, therapists and pharmacy staff on each ward, to discuss at the monthly ward governance meetings.

Age indications for carotid sinus massage: a case for maintaining the status quo?

A 43-year-old man was referred with a history of unexplained falls associated with transient loss of consciousness. He had evidence of cardioinhibitory carotid sinus hypersensitivity (CSH) on carotid sinus massage and subsequently confirmed to have periods of symptomatic asystole on an implantable loop recorder, consistent with a diagnosis of cardioinhibitory CSH.

Circadian and orthostatic blood pressure is abnormal in the carotid sinus syndrome.

The authors' objective was to determine circadian blood pressure behavior and the prevalence of orthostatic hypotension in patients with cardioinhibitory carotid sinus syndrome. A prospective consecutive series of 160 patients (mean age, 72 [65-83]) with recurrent syncope attributed to cardioinhibitory carotid sinus syndrome was recruited. Mean maximal slowing of heart rate was 4.

Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial.

Objective: To determine the effectiveness of multifactorial intervention after a fall in older patients with cognitive impairment and dementia attending the accident and emergency department.

Design: Randomised controlled trial.

Participants: 274 cognitively impaired older people (aged 65 or over) presenting to the accident and emergency department after a fall: 130 were randomised to assessment and intervention and 144 were randomised to assessment followed by conventional care (control group).

Presence of a carotid bruit in adults with unexplained or recurrent falls: implications for carotid sinus massage.

Background: Carotid sinus hypersensitivity is a common cardiovascular cause of unexplained or recurrent falls in older adults. Effective treatment is available once carotid sinus hypersensitivity is identified. Carotid sinus massage is the only practical method for achieving a diagnosis.