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Patient fall

Asked to see

Check for injury before moving the patient; use safe manual handling (flat lifting equipment if spinal or hip injury suspected).

Anticoagulated or on antiplatelets (not aspirin alone) with a head injury: consider CT head within 8 hours.

Act now

  1. 1

    Do not move the patient if spinal injury is suspected until assessed.

  2. 2

    Analgesia; neuro observations if head injury.

Assess

  • ABCDE, GCS, neuro exam, C-spine, hips, wrists, ribs, head and face. Was it witnessed? Loss of consciousness?
  • Why did they fall: syncope, arrhythmia, postural drop, hypoglycaemia, infection, delirium, drugs, poor footwear or environment.

Investigations

  • Lying and standing BP, ECG, glucose, bloods as indicated.
  • X-ray suspected fractures. CT head per NICE NG232 criteria (e.g. GCS <15 at 2 h, suspected skull fracture, seizure, focal deficit, >1 vomit; anticoagulant or antiplatelet use).

Manage

  • Comprehensive falls assessment for inpatients aged 65+ (or 50–64 at higher risk): medication review, vision, continence, delirium, cardiovascular causes, mobility, footwear.
  • Inform the patient's family and complete an incident report.

Escalate when

  • Reduced GCS, focal signs, suspected hip or spinal fracture, or head injury on anticoagulants: senior review.

Written to current guidance (NICE NG249, NG232) · sources checked 14 Nov 2026. We watch NICE for updates weekly.

Sources (2)

Reviewed by Aboodee Alhasso, MPharm MRCPharm IP on 14 Nov 2026

Calculators for this

For healthcare professionals, as an aid to clinical judgement — not a substitute for it. Follow your local policy and ask a senior when in doubt.