“If you don’t stand for something, you’ll fall for anything”
-Malcolm X
Fall Statistics
2800 workers in Manitoba are hurt every year due to falls
69% of all workplace falls in Manitoba happen on level ground
At least 2 deaths reported per year due to falling
-WCB Statistics
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2800 are just the ones that are reported, most likely many more occurring or Near Misses In the US, falls are the number one cause of occupational injuries. more likely to suffer a serious or life-threatening injury at work from a slip/trip or fall
Patient Falls
Modified Schmid Tool
Hendrich Protocols
Staying on Your Feet
Older Adults
Children/Adolescents
Modified Schmid
Mobility
Mentation
Elimination
Prior Fall History
Medications
Environmental Factors
Hendrich II
Mental/Emotional Status
Dizziness/Vertigo
Medications
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Acute care setting only
Staying on Your Feet ‐
IMPACT
www.preventfalls.ca
Older Adults
Home Safety Checklist
Personal Prevention
Home Balance/Strength Exercises
Children
Injuries at Home
Playground Safety
Sports Injuries
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Environmental (home, sports, playground) Medications Where’s the gap?
Patient Falls vs. Employee Falls
We can’t help our patients if we can’t help ourselves
PREVENTION!
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There is much debate surrounding how to deal with a patient that is falling. We need to look at the root causes in the first place. Prevention is the best way to deal with falling – reduce the chance of the falling at all.
Staff Injuries
Pride
Fractures
Dislocations
Sprains/Strains
Concussions
Cuts/Scrapes
Bruises
Staff Fall Consequences
Staff shortages
Lost workdays
Decreased productivity
WCB costs
Fall Prevention in the Workplace
1. Hazards
2. Behaviours
Fall Hazards
Spills
Obstructions
Uneven Surfaces/Flooring
Poor Lighting
Improper Use/Installation of Floor Mats
Weather Conditions
Spills
Use of fluids = risk of spills
Can be difficult to spot
Small amount of fluid = BIG fall risk
Spills Prevention
Clean up yourself
Report spill
Warn others
Signage
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Do not leave the site of the spill, as others may also be at risk of falling
Code Brown
Do not clean up spill yourself when:
Unknown substance
Unaware of safe cleaning method
Special training required to contain spill
Obstructions
Obvious Oblivious
Obstruction Prevention
Awareness is key
Clean and tidy storage areas
Remove cords from walkways
Close doors/drawers when not in use
Poor Lighting
Should be common sense, but is it?
Poor Lighting Prevention
Flashlights
Emergency lighting checked regularly
Report/replace burned out bulbs
Move slowly/carefully in dim lighting
Uneven Surfaces
Indoors
Uneven flooring
Door jambs
Broken stair edges
Outdoors Cracks in sidewalks
Parking lots
Holes/divots in ground paths
Floor Mats
Entrance/Hallway
Fall Mats
Anti-Fatigue Mats
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3/8 inch = 9.5 mm is enough to cause a trip Floor mats can bunch up/fold over, become wet in winter/rain
Prevention
Beveled edges
Lie Flat
No-skid backing
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Winter slip/trip stats? Particularly bad winter – never ending!
Weather Conditions
Ice is a fact of life in Manitoba
Parking lots/sidewalks
Don’t forget about indoors!
Winter Fall Prevention
Cleaning pathways as soon as possible
Sand/salt/de-icer
Vigilance/awareness
Proper footwear!
Indoor Winter Fall Prevention
Floor maintenance
Clean/replace mats as needed
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Housekeeping departments will clean front entrances more
Floor Cleaning Products
Housekeeping
Community –
client homes
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Clean floors may equal slippery floors. Do not assume that every product is safe, particularly in client’s homes.
Fall Risk Behaviours
Obstructed Vision
Poor Housekeeping
Shortcuts
Rushing
Complacency
Improper Footwear
Obstructed Vision
Large boxes/loads
Tall carts
Stairs
Visual Defects
Obstructed Vision Prevention Break up the load
Contrast
Prescription
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When using stairs, ensure that you have one hand available for the railing at all times!
Poor Housekeeping Debris
Storage Rooms
Small items on floor etc.
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Clean up after yourself for the sake of you and others
Shortcuts
Quicker is not always better
Dark
Slippery
Unknown Hazards
Rushing
More likely to slip while running
Hazards not seen in time
Momentum increases injury risk
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Momentum – outside eg.
Prevent Rushing Injuries
Ensure pathways clear
Move slowly and deliberately
Complacency
• Tired/preoccupied
• Unaware
• Ignoring Hazards
Improper Footwear
Grip/Traction
Function over Fashion
Footwear Safety Considerations
Temperature
Electrical Shock
Static Electricity
Chemical Exposure
Fluids
Indoor vs. Outdoor
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Winter footwear does not mean runners! Proper winter footwear should have: Good traction in snow/slip resistance to ice – deep tread pattern for snow, slush and dirt Upper part of boot flexible but firm – foot should not slide around in boot Allow for warm socks Sole made of a material that won’t harden when cold – eg. Natural rubber Flat sole, low heel
Self Help Solutions
Self Preparedness
Core Strength
Balance
Core
Almost every movement is initiated or transferred through the core.
Provides spinal stability & balance for entire body to resist forces applied to it
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Essential for the maintenance of upright posture
Not A Six Pack!
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Beach muscles are not necessarily important muscles! Abdominals (TA), Back/Spinal Extensors (Multifidus), Hip/Gluteals, Pelvic Floor, Shoulder girdle Global muscles vs stabilizing muscles Corset of muscle providing stability They are known to contract prior to any limb (arm or leg) movement and so they function in keeping the centre, or core of the body rigid during all movement. Thus retraining these muscles to contract at the right time is the fundamental theory of core stability.
Core
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GROUP of trunk muscles that surround the spine working together to achieve strength and stability – muscles contracting together to provide support to the spine & pelvis during movement
Core Stability
Strength is not enough!
Proximal Stability for distal mobility
Need CONTROL of position & movement of trunk
Coordination & balance
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Using the right muscles at the right time in the right order – recruit trunk muscles and learn to control position of lumbar spine during dynamic movements The ability of the core muscles to work in an efficient and coordinated fashion to maintain correct alignment of the spine and pelvis while the limbs are moving. How well the core muscles can hold the spine/trunk still and relatively stable while the extremities are moving (strength?). Without core stability the lower back is not supported and can be injured causing strain Lunge - Accomplishing this maneuver without deviation requires the deep trunk muscles to control the spine, pelvis and hips, while lifting the body’s weight. Clean & Jerk
Functional Core Strength
Proprioception
Proprioception
Exercises
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Stork stand, eyes closed. Rock on toes and heels, perturbation (ping pong), 747 Advanced: BOSU ball
Footwear
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Shape of shoe bottom Relates to the type of arch you have Straight last – best for “fallen arch” – flat foot Semi-curved last – “normal” foot Curved last – best for high arch – rigid What does your arch look like? – Look at footprint after getting out of the shower/tub/pool etc. Which picture does it resemble?
Wear Pattern
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Pronation – flat arch/fallen arch Supination – high arch
Shoe Buying Tips
Go shopping at the end of the day
Move around in the shoes
Don’t wait to break them in
Back to Basics
Fix what you can
Report what you can’t fix
Warn others of hazards
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Fix: environment, equipment etc. Safety is everyone’s responsibility