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Geriatric fall prevention tips after POTUS trips, falls

EMTs, paramedics and firefighters have a responsibility to identify fall hazards and share prevention tips with patients and at the public events we host

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President Joe Biden falls on stage during the 2023 United States Air Force Academy Graduation Ceremony at Falcon Stadium, June 1, 2023, at the United States Air Force Academy in Colorado Springs, Colo.

AP Photo/Andrew Harnik

President Biden, the White House says, is OK after tripping and falling on the stage at the U.S. Air Force Academy graduation.

Biden congratulated and shook hands with cadets after they received their diplomas. Biden, as shown in the below video, turned to return to his seat, took a couple of steps and tripped over a sandbag. Biden fell to the stage and was quickly assessed and assisted to a standing position. Biden walked to his seat and looked to make some remarks to the people near him who laughed and smiled as he passed.

Fall prevention responsibility

Geriatric falls, as paramedics know, are no laughing matter. A fall from a standing position leads to a lot of 911 calls. Many of those calls result only in a lift assist for the patient into a chair or bed, and no transport after an assessment for injuries.

Alternatively, many falls result in head injuries, orthopedic injuries and soft tissue injuries that might require immobilization, pain management and monitoring during transport to an appropriate receiving facility. As you have likely experienced, some patients will resist assessment and treatment because they are scared of not being able to return home. Tragically, many in-home falls lead to a loss of independence from geriatric patients who are never able to return to their home and live independently.

Don’t dismiss a patient’s fall as clumsiness or just an accident. A geriatric patient may have fallen because of side effects from their medication or an underlying medical condition. Perform a primary and secondary assessment, including a focused history and physical examination, before making a treatment plan and transport decision.

Geriatric fall prevention tips

Paramedics, EMTs and firefighters, during any call to service into an elderly patient’s home, have a responsibility to identify fall hazards and encourage the patient, other residents of the home and caregivers to mitigate those hazards. Here are a few fall prevention tips to share:

  • If you have a cane or walker you are supposed to use, use it.

  • Don’t get out of bed or up from the toilet or chair suddenly. Sit upright, pause, take a breath, then push up while also standing up with the muscles in your legs.

  • Don’t walk and attempt to use or read your smartphone or tablet at the same time. Especially, if you are walking up or downstairs.

  • Move cords for lights, TVs and other appliances out of walking paths.

  • Turn on lights as you move through the house and add motion-activated nightlights in the bedroom and bathroom.

  • Know where your pets are before you move.

  • Use railings when going up or down the stairs.

  • Wear shoes instead of slippers or socks for better traction.

  • Don’t use slippery area rugs or throw rugs in the kitchen, hallways or bathrooms.

  • Install handholds in the tub and near the toilet.

Fall prevention at department events

President Biden wasn’t the only person at risk of a trip and fall on the Air Force Academy stage. Anyone could have tripped over the black sandbag lying on a black stage.

The apparatus bay or interior of the ambulance is a great backdrop for a department announcement, promotion ceremony or media appearance, but there are many risks that are obvious to EMTs, paramedics and firefighters that might go unseen to laypeople. As your agency or department prepares for and hosts public events, make sure to do a risk assessment and mitigation of trip and fall hazards, environmental risks and other safety risks.

Additional reading

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.