Presentations
- Collapse
- Dizziness and vertigo
- Electrolyte dysfunction
- Fear of falling
- Fractures
- Frailty
- Functional decline
- Head injury / subdural haematoma
- Hyperglycaemia / hypoglycaemia
- Metabolic disorders
- Multiple comorbidities
- Postural hypotension
- Recurrent falls
- Seizures
- Sepsis
- Syncope
- Vitamin D deficiency
Conditions
- Adverse drug reaction / effect
- Alcohol and substance abuse disorders
- Anaemia
- Arrythmia
- Autonomic failure
- Cognitive impairment
- Delirium
- Dementia
- Diabetes
- Heart failure
- Hypovolaemia, such as GI bleeding
- Incontinence
- Movement disorders, e.g. Parkinson disease
- Musculoskeletal conditions, e.g. arthritis
- Myopathies, including proximal myopathy
- Neurological conditions, including epilepsy and peripheral neuropathy
- Osteoporosis
- Stroke
- Vestibular disorders
- Visual impairment
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Carotid sinus hypersensitivity
- Hereditary degenerative neurological conditions
- Parkinson disease, plus disorders
- corticobasal syndrome
- multiple systems atrophy
- progressive supranuclear palsy
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Consequences of falls and mobility issues, including pressure injuries, long lie, rhabdomyolysis, dehydration, and psychological
- Epidemiology of falls in Australia and Aotearoa New Zealand
- Fall rates in older people
- Health burden of falls in older people and cost at population level
- Intrinsic and extrinsic risk factors for falls
- Pharmacologic factors associated with an increased risk of falls
- Vitamin D and calcium supplementation
Examinations
- Audiology and vestibular testing
- Cardiovascular (CV) exam
- Hallpike manoeuvre
- Lying and standing blood pressure
- Musculoskeletal examination
- Neurological examination, including sensation
- Screening continence
- Tilt table testingM
- Vision, including depth perception
Investigations
- Ambulatory blood pressure monitoring
- Bloods - haematology, biochemistry including glucose, vitamin D, calcium, liver function tests
- Brain imaging
- Cardiac - ECG, Holter, echocardiogram, event recorders
- Dual energy x-ray absorptiometry (DXA)
- Trauma series, including CT scanning
- Vestibular function tests
Clinical assessment tools
- Falls risk factor assessment tools
- Gait and mobility speed assessment, including timed up and go test
- Medication review
- Application of individual risk / benefit analysis of anticoagulation in falling patients
- Awareness of compromises between patients’ safety and improved mobility and dignity of risk
- Body of evidence around falls prevention trials
- Bone health
- falls and fracture risk
- screening for and treatment of osteoporosis
- vitamin D supplementation
- Gait aid prescription
- Identification and management of recurrent falls
- Multidisciplinary team approach in the assessment and management of falls
- Outcomes and implications of falling, including legal reporting
- Risk factors for falls
- Strategies to assist patients and their family or carers with the psychological fear of falling
- Understand the strategies to prevent and mitigate the risk of injury from falls in different settings, such as inpatient and community residential aged care facilities, including:
- ensuring appropriate supervision
- falls alarm
- footwear
- hazard assessment and modification
- hip protectors
- incidental activity, exercise
- retraining activities of daily living (ADLs)
- strength or balance training
