Does the Clinical Frailty Scale predict re-presentations to the ED in elderly community-dwelling people following an initial presentation from a fall?

Falls in the elderly community-dwelling population are a common presentation to Australian Emergency Departments (ED). The Australian Institute of Health and Welfare reported an estimated 125,000 people aged 65+ were hospitalised due to falls in 2016/17. Fallers presenting to the ED that are elderly and frail, may then be discharged directly home.

The Clinical Frailty Scale (CFS) has been widely used and is associated with mortality, comorbidity, increased length of stay and falls (Church 2020). Despite its expansive utilisation, no studies have assessed the correlation of CFS scores with re-presentation to the ED following a fall.

Improving the ability to identify patients who are at risk of re-presenting with falls could aid in focusing physiotherapy and allied health resources towards these patients during their initial ED presentation.

LOVE-DIVA

Peripheral intravenous catheters (PIVCs) are small plastic tubes placed in a patient’s vein for the delivery of intravenous fluid and medications. In the emergency department, many patients present with difficult intravenous access and require multiple insertion attempts to successfully place a PIVC. This can be time consuming for clinical staff, costly for hospitals, and painful for patients. Correct device selection is a key strategy to ensure first-time insertion success.

This study will recruit 406 adult participants at two emergency departments in order to test if novel PIVCs with a retractable guidewire (AccuCath Ace™ Intravascular Cannula, BD), compared to standard care, are effective at increasing first-time insertion success for patients with difficult vascular access.