Emergency department and A+E rotation preparation

 Published: 20/04/2023

Disclaimer: I worked as part of an acute and frail team, but my advice is transferrable to any AMU (Acute Medical Unit) or ED (Emergency Department) rotation or placement. 

Preparation advice 

• Practice completing thorough social histories of the home environment e.g. equipment, indoor and outdoor mobility baseline and FRAT Score 
• Knowledge of factors contributing to falls, balance outcome measures and falls management resources e.g. Get Up and Go Booklet and balance groups in the community
• Awareness of the NICE Falls guidelines
• Knowledge of frailty and comprehensive geriatric assessment
• Fit for frailty guidelines from the British Society of Geriatrics 
• Frailty syndromes  (page 8 of the PDF)
• Knowledge of types of delirium and how delirium differs from dementia 
• Common conditions: falls, alcohol-induced falls or admissions, pubic rami fractures, humerus fractures, Parkinson's disease and frailty
• Knowledge of symptoms of fracture and Occult fracture guidelines (e.g. missed fractured neck of femurs)
• Awareness of pressure ulcers and pressure care (to enable referral to Occupational therapists for at-discharge pressure care equipment)

On the rotation

• Utilise a social history crib sheet to collect all the important relevant information e.g. continence, equipment and mobility. Occupational therapists are the best resource for learning how to take thorough social histories from
• Learn from your peers and seniors 

Other resources

• CSP (2015) Get up and Go - a guide to staying steady English Version: https://www.csp.org.uk/publications/get-go-guide-staying-steady-english-version
• British Geriatrics Society (2022) World Guidelines for falls prevention and management in Older Adults: A Global Initiative https://www.bgs.org.uk/wfg
• Clinical Physio Balance On-demand webinar (also available on their membership site)
• Clinical Physio Patients that fall on-demand webinar (also available on their membership site)