title: Coordinating Care for FallsviaEmergency Responders: A Feasibility Study of a Brief At-Scene Intervention.
abstract: Falls account for a substantial portion of 9-1-1 calls, but few studies have examined the potential for an emergency medical system role in fall prevention. We tested the feasibility and effectiveness of an emergency medical technician (EMT)-delivered, at-scene intervention to link elders calling 9-1-1 for a fall with a multifactorial fall prevention program in their community. The intervention was conducted in a single fire department in King County, Washington and consisted of a brief public health message about the preventability of falls and written fall prevention program information left at scene. Data sources included 9-1-1 reports, telephone interviews with intervention department fallers and sociodemographically comparable fallers from three other fire departments in the same county, and in-person discussions with intervention department EMTs. Interviews elicited faller recall and perceptions of the intervention, EMT perceptions of intervention feasibility, and resultant referrals. Sixteen percent of all 9-1-1 calls during the intervention period were for falls. The intervention was delivered to 49% of fallers, the majority of whom (75%) were left at scene. Their mean age (N= 92) was 80 ± 8 years; 78% were women, 39% had annual incomes under $20K, and 34% lived alone. Thirty-five percent reported that an EMT had discussed falls and fall prevention (vs. 8% of comparison group,P< 0.01); 84% reported that the information was useful. Six percent reported having made an appointment with a fall prevention program (vs. 3% of comparison group). EMTs reported that the intervention was worthwhile and did not add substantially to their workload. A brief, at-scene intervention is feasible and acceptable to fallers and EMTs. Although it activates only a small percent to seek out fall prevention programs, the public health impact of this low-cost strategy may be substantial.
authors.affiliation: Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, USA; Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Phelan
authors.affiliation: Medical College of Wisconsin Affiliated Hospitals , Milwaukee, WI , USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Herbert
authors.affiliation: EMS Division, Public Health - Seattle and King County , Seattle, WA , USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Fahrenbruch
authors.affiliation: Department of Family Medicine, University of Washington , Seattle, WA , USA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Stubbs
authors.affiliation: Department of Health Services, School of Public Health, University of Washington , Seattle, WA , USA.
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
keywords: accidental falls; aged; emergency medical technicians; health services for the aged/organization and administration; perception; prehospital care; public health