Grant: Project Grant

Falls are common for older adults. Over the course of a year, a third of people over the age of 65 will have a fall. Every year, Canadian emergency departments treat over half a million older adults who had a fall. A small number of older adults who fall develop a brain bleed because of the fall, which is a serious condition that may cause death. Brain bleeds are diagnosed by brain scans (CT scans). Emergency doctors struggle to know when an older adult is at risk of a brain bleed and are looking for guidance on which patients need a brain scan. We created a bedside test (the Falls Rule) which identifies who needs a brain scan. The Falls Rule is simple and fast to apply, and ensures the right people have a brain scan. These days there are long delays to be seen by a doctor in the emergency department. Waiting in the emergency department can be uncomfortable, noisy and disorienting for older people. In the future, the Falls Rule could reduce waits by having the brain scan ordered at triage. We will use this bedside test (the Falls Rule) for older people who come to emergency departments after a fall. The doctor will order a brain scan if the Falls Rule is positive. Our study will follow everyone for 30 days to be sure the Falls Rule does not miss a brain bleed. If we show the Falls Rule is safe and effective, emergency doctors in Canada and other countries will be able to use it. Brain bleeds would be diagnosed quickly, patients would be safely discharged from the emergency department faster and hospitals would save money.