SECTION A: PROTECTION AND PROFESSIONAL ROLES
Within the medical profession, there will always be a potential for emergencies.* Within an inpatient facility setting, the physical therapist’s responsibility is to fully understand and be aware of the various “codes” that may be announced that directly influence patient safety. On hearing the code alarms, the physical therapist should follow facility protocols to ensure patient and staff safety. These “codes” can include patient abduction, on-site threat, environmental threat, and individual patient emergencies. The appropriate and correct action is required in all cases.
All patients should be evaluated for fall risk at every visit, particularly those over 65. The patient should not only be asked if they have experienced a fall since the previous visit but the definition of a fall should also be clearly explained.
According to the World Health Organization, “A fall is an event which results in a person coming to rest inadvertently on the ground, floor, or other lower level.” It does not have to result in injury, and many older adults will deny falling if they are not injured. It is, therefore, important to ensure that they understand what constitutes a fall and then determine if they have fallen.
Table 8–1 shows protocols for a situation of a patient falling during therapy. During any family contact, no indication of guilt should be made, facts should be reported, and the family should be referred to appropriate management for follow-up as needed. Everything from the fall to the follow-ups should be carefully and accurately documented immediately to ensure accurate and full recollection of the incident. If an incident was witnessed, get a statement from any witness.
TABLE 8–1Emergency response. ||Download (.pdf) TABLE 8–1 Emergency response.
|Location ||Policies ||Obvious Injury ||No Obvious Injury ||Follow-Up ||Who to Contact |
|Outpatient clinic ||Follow clinic policy and procedures ||Call 911 for medical support ||Get the patient up, and take vital signs; if normal, continue with caution and patient consent ||Continue to monitor the patient and only allow them to leave the clinic if you are sure they are stable and safe || |
Primary care physician
Management of the facility
|Home health setting ||Follow agency policies and contact the agency immediately ||Call 911 for medical support ||Get the patient up, and take vital signs; if normal, continue with caution ||Continue to monitor the patient throughout the session, and do not leave the home until you are sure the patient is safe and stable and not alone || |
Home health agency
Primary care physician
Family as appropriate with patient consent
|Inpatient setting ||Follow facility protocols ||Call nursing, emergency response team, and/or MD to the location || |
Call nursing and/or MD at the location
Get patient up and continue per MD recommendations
|Complete all facility paperwork and ...|