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Falls Quiz
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A patient cannot clearly recall the events surrounding a fall. Which approach is most useful for establishing what happened?
- A Obtain a collateral history from someone who witnessed the fall You picked ✓
- B Ask the patient to try to recall the event again and fill in any gaps in their memory You picked ✕
- C Examine the patient for injuries and focal neurological deficits before taking any further history You picked ✕
- D Review the patient's medication list for drugs that can cause postural hypotension or sedation You picked ✕
- E Assume the fall was mechanical unless proven otherwise You picked ✕
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Incorrect
The answer is A: Obtain a collateral history from someone who witnessed the fall
Explanation
Why A is correct
See Who. Option A is correct. A collateral history (an account of the event from someone other than the patient, such as a witness, relative or carer) is one of the most useful tools after a fall. The SimpleMed article explains that patients can be unreliable historians after a fall, especially if they have a condition such as dementia (a condition that affects memory and thinking) or lost consciousness. A witness can say how the patient fell, whether they looked pale, jerked or went limp, how long they were unresponsive and how they recovered. Those details help to tell a syncope (a brief faint caused by a temporary drop in blood flow to the brain) from a seizure or a trip, which changes the tests and treatment. Information from witnesses is most useful when collected soon after the event. So ask: who else was there, and did anyone see it happen? A simple memory aid: the first of the fall questions is "who", because a witness may know what the patient cannot.
- Collateral history: an account of the event from a witness, relative or carer
- Why it is needed: patients can be unreliable historians after a fall, especially with dementia or loss of consciousness
- What it adds: a witness can describe how the patient fell and recovered, which helps to tell a faint from a seizure or a trip
Why the other options are incorrect
- B. Ask the patient to try to recall the event again and fill in any gaps in their memory: Clarifying the patient's own recollection is useful, but it is not the most useful approach when they cannot remember clearly; a collateral account can supply details the patient may never recall, especially after loss of consciousness. Your answer
- C. Examine the patient for injuries and focal neurological deficits before taking any further history: Examination is essential after a fall, but it cannot reconstruct the sequence of events; many causes such as syncope or seizure leave a normal examination, so it is less useful for establishing what happened. Your answer
- D. Review the patient's medication list for drugs that can cause postural hypotension or sedation: Medication review may identify a potential cause, but it does not establish the events surrounding the fall; a witness account is more useful when the patient cannot clearly recall what happened. Your answer
- E. Assume the fall was mechanical unless proven otherwise: A mechanical fall means a simple trip or slip, and assuming this risks missing medical causes such as orthostatic hypotension or an arrhythmia. The cause should be investigated, not presumed. Your answer
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More questions from this set. Start the quiz to answer them and see each explanation.
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1
Which medication class is most directly associated with an increased risk of falls because it can cause drowsiness and reduced awareness?
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2
A 72-year-old woman becomes light-headed and briefly dizzy when she stands up quickly from a chair. Her symptoms settle after a short period while she remains standing. Which physiological change most directly explains the initial fall in arterial blood pressure on standing?
Revise before you test
Review SimpleMed's doctor-written article, then return here to check recall.
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