Factors that Affect EMS Transports for Fall Victims

An article by Faul et al. in the American Journal of Preventive Medicine analyzed data from more than 900,000 calls to EMS providers in 2012 that involved falls by people 65 years or older. The researchers examined factors such as the sex of the injured person, the location of the fall, and geographic setting and correlated these factors with the likelihood of being transported to a trauma facility.

Nursing home residents are more frail and are older than adults who live in the community. Thus, it is not surprising that people who fell in institutional settings were 3.5 times more likely to be transported than people who fell in their homes. Victims who fell in business locations such as restaurants or stores were the least likely to be transported.

Sex and age affected transport rates. Female victims were 30% more likely to be transported than men. Individuals who were 85 and older were 14% more likely to be transported than younger victims.

About 20% of the calls did not result in transport. The primary reason was that 57% of those not transported refused care. This percentage of calls not resulting in transport was twice as high as that for patients who had not fallen.

Geography slightly affected transport rates. For instance, victims who fell in rural areas were more likely to be transported, followed by falls in wilderness environments. Victims in urban areas were transported at the average rate, while victims in suburban areas were slightly less likely to be transported.

The training of the EMT also affected transport rates. Nurse providers were the most likely transport patients. They ordered transport at 1.47 times the average rate. EMT-Basic providers were more likely than EMT-Intermediates to transport patients.

The authors commented that education on falls prevention may be in order for the patients who are not transported, since patients who have suffered a fall may be more willing to accept and implement advice on how to prevent them.