The 72 hour fall watch occurs after a fall has already happened and involves a series of comprehensive assessments of the resident’s condition to make sure that there was no injury which was missed.When a fall occurs in a nursing home, the staff member who learns of the fall first, usually a CNA, summons a nurse to evaluate the resident’s condition. If there are obvious signs of serious injury the rescue squad will be summoned immediately to come to the nursing home to take the resident to the emergency room.
Some obvious signs of serious injury after a nursing home fall include:
- Obvious fractures (such as one leg shorter than the other, legs internally or externally rotated or pointing inward or outward)
- Significant bleeding
- Loss of consciousness
- Sudden onset of headache or nausea
- Uneven pupils
- Confusion or mental status changes
- Increasing tiredness or weakness as the hours progress
- Weakness to one side that was not present prior to the fall
- Significant bruising
- Pain to a specific area that was impacted during the fall
- Unrelieved pain
- Difficulty breathing or shortness of breath
When there are not obvious serious injuries, the nursing staff has to notify the resident’s family and the resident’s attending doctor. The doctor will make any orders he or she thinks are needed such as to have the resident sent to the hospital or other specific kinds of care to be done in the nursing home. Many times, the doctor relies upon the nursing staff to make a good assessment of the resident’s condition and will not come to the nursing home immediately to evaluate the resident’s condition.
If the resident remains in the nursing home, good nursing homes institute a 72 hour fall watch. During the 72 hour fall watch, each nurse who comes on duty completes at least one comprehensive assessment of the resident’s condition and charts it, often a special form designed specifically for the 72 hour fall watch.
The shift-by-shift charting of the resident’s condition is important for tracking the onset of symptoms of a serious injury which may not have been apparent at the time of the immediate post-fall assessment.
One kind of injury that does not manifest itself immediately after a fall is a subdural hematoma or intercranial hemorrhage, sometimes referred to as a brain bleed. Brain bleeding is a silent killer after nursing home falls because victims seem fine right after the fall but, as the bleeding in their head continues, they get nauseated, headaches increase, they become drowsy, and weakness progresses. If the onset of symptoms of a brain bleed is not caught immediately, the results can be deadly. Ask your physician to order neuro checks every 4 hours during the 72 hour fall watch.
As experienced Chicago nursing home lawyers, we know that documentation of the 72 hour fall watch is kept at every decent nursing home and know to ask for it in any nursing home fall case.