Unwitnessed fall

[Koalified]

I was talking to a charge nurse on a different unit one day and she said per hospital or unit protocol (not sure which), if there is an Unwitnessed fall, you have to call rapid response even if the pt is alert and oriented, is able to get up, and denies hitting head. I think this is a waste of resources. If i had found my AOx4 pt down, I would just help the pt up, get vitals, assess, page MD, and file report. What do you guys think? What is the policy in your unit?

[Castiela]

I'm not sure what Rapids are. Our policy for unwitnessed falls is vs/ neuro vitals q15minx2, q30min x2, q1h x4 then q4h for 24hrs +calling the docs/report

[Davey Do]

If i had found my AOx4 pt down, I would just help the pt up, get vitals, assess, page MD, and file report. What do you guys think? What is the policy in your unit?

Agreed.

Sometimes the Patient just plops on their behind, or something similar, denies any dizziness or other discomfort, I just do an assessment, note it, complete an ERS, contact the family, House Sup, Doc, and be done with it.

We had a Patient fall in the shower recently, and was allegedly initially unconscious, and I called a Rapid Response Falling Star and began the assessment. The House Sup, a Nurse from ICU and RT showed up, and we got orders for an ER visit after being placed on a back board. When the Patient returned to the unit, in addition to documentation and notifying the Family, we did the whole neuro checks/VS thing.