What if the patient is in critical care and is comatose or if the patient cannot get up without assistance? How is the tool used?
Critical care patients may exhibit many of the risk factors during highly acute periods. However, if they are comatose and/or on a ventilator, or simply not able to rise at all without assistance, they do not have an opportunity to fall, even though there are risk factors. They should be assessed in the same manner, and risk factors should be documented. As soon as they have a potential to attempt to get up, they should be placed on a protocol for fall prevention. Interventions should always be matched against the risk factors when the patient has a potential to fall. Falls are rare in critical care, but when they do occur they can be very serious. These falls often occur when patients awaken from comatose states or in the early days of mobility attempts without staff knowledge. Severely compromised or debilitated patients often have many risk factors but are simply unable to rise without considerable assistance of 1 or more personnel. These patients are often more at risk for falls fr
