- Hey guys welcome back to the DrCliffAuD Vlog.
This is Vlog Number 27
and it just so happens to be the 4th of July today,
but we're gonna take a little break
from our celebration to kind of fill you guys in
on what happened this week in the clinic,
and it actually was not a good thing.
We had a patient fall inside of our clinic
and we actually had to call 9-1-1.
Just to give you a little bit of background.
I had a new patient coming to my clinic,
was the husband of an existing patient that I have,
and when I was going through the health history
of this individual, it turns out this individual
had a history of atrial fibrillation.
Basically he has a heart condition,
and when I was asking him about if he ever felt dizzy
or had vertigo or had any risk of falling,
he had mentioned that he had never fallen before,
but sometimes when he gets up from sitting down
for a long period of time,
sometimes it can be a little light-headed
and he has to hold on to something.
And so that was you know relatively early
in the appointment, but like I always do,
I took him in the back and took him into the sound booth,
warned him about the little lip that there
is going up the ramp into the sound booth,
because the one thing that I am deathly afraid of
is people falling, going into and coming out of the booth,
because of the little lip that's there.
He got all the way through testing, no issues,
went back in, took the inserts out of his ears,
took the bone conduction device off of his head,
and he stood up.
We chat for just a second,
you know I explained to him that we're gonna head back
into my room and go over the results of the hearing test
and he asked if he could use the restroom.
I said absolutely,
I walked out the into the hallway and turned around
and told him that it's just kind of down the hall
and to the right, and so he headed off that direction,
I headed in the opposite direction
and went into my room to get things set up.
And then...
- And then I heard this thump and someone kind of moaned
and I was like, "Oh that's strange."
So I immediately of course stood up,
opened up my office door and then on the floor
was this gentleman,
and I knew that it was the person
that you were doing your hearing test on,
but so immediately, I just kind of got down
on my hands and knees.
He was awake and alert kind of like
did a really quick head-to-toe look at
to make sure there was like no large amounts of blood
spewing anywhere.
- And that was one thing; he was on blood thinners,
that's another thing that I uncovered initially
and I remember seeing that there were some scrapes
on his knees but for some reason
they were not bleeding very much,
and I should just fill you in on this.
Ashley who you've met in a couple of vlogs
prior to this, of course is my wife
and she's also a registered nurse
and she's actually had experience working
in the emergency room,
as well as an urgent care
and so in terms of having someone on staff
who is really good in those situations,
I would say that she is probably
the highest level of expertise
that you could ever possibly want inside of a clinic
from a medical standpoint,
and an emergency medical standpoint,
and so basically I think it was,
wasn't it Courtney who came up
and told me that he had fallen?
- Yeah so she came,
I think she must have heard me
speaking to the patient and she immediately came back,
and I just prompted her to call 911,
because you know I wasn't really quite sure
the full extent of this gentleman's history,
but I knew that he was probably over the age of 65
and my initial concern was one,
I want to make sure that he's awake and he's breathing
and all of that was good thus far,
but I just, at our clinic
we don't have any of the supplies
that one would need if anything were to happen
any more gravely than what was at the current situation.
- Which makes me question if we need to like
step up our emergency preparedness
if stuff like that were to happen
because this is actually the second time
that this has happened, I think within a year
and which kind of leads me to this next part,
which is individuals who have a hearing loss
are if you even have a mild hearing loss,
you are three times more likely to experience a fall,
and that's kind of a scary number,
and this is from data out of Johns Hopkins Dr. Lin,
and I believe it was in 2012
they identified that the risk actually
increases with an additional ten decibels
of hearing loss on average,
increases the risk by 1.4,
which is like a massive increase in risk of falling
and this is when they're taking into account,
age and gender and all of this stuff
and they're kind of separating out
that is being the root cause of it
because I think a lot of people would just assume like,
"Oh well individuals get older,
they get hearing loss"
and then as you get older you also tend to lose balance.
Well they controlled for those factors
and hearing loss in and of itself
is another leading factor of whether
or not someone would experience a lot of falls,
and that's dangerous when you start getting
out of the clinic.
- Yeah I mean I think that there's,
you know, I think in my own personal life
I take for granted all of my senses
that I just innately have the ability to use,
and I think once you start to have those compromised,
you don't really realize how important they are
to your active everyday activity,
everyday events that you take part in,
and equilibrium is a huge thing
and just working in hospitals and emergency rooms,
falls is a huge reason that causes
a lot of scary things for patients.
It can cause lots of traumas.
- Exactly it leads to- - It can cause that.
- To other things and the older that you are and fall,
the quicker that it actually leads to death.
I mean when someone has a broken hip,
I don't know what the statistics are.
I can't remember them,
but I heard some startling statistics;
something that said like within X amount of months
after a fall beyond the age of 80 or whatever
that number was, that mortality kind of sets in,
but which is kind of scary but I know that there
is at least one hearing aid manufacturer right now
that has developed technology
inside of their hearing aids
that can identify once someone has fallen
and actually alert a family member
or someone who's a caregiver for that individual.
And it kind of reminds me I mean Courtney our front office
staff person came up,
and she's like "Cliff it's a good thing that
he didn't fall in the room in the restroom
with the door locked."
I mean we do have the way to emergency open the door
but still like we wouldn't have known
and if he would have hit his head and passed out-
- It would've been scary. - Like it would have
just been a really really bad situation.
So it can help I mean I'm trying to think of other ways
to you know identify if someone has fallen,
I'm thinking from a clinic perspective,
there's not a whole lot that we can do.
We can put some kind of an emergency system
inside of a restroom if someone has fallen,
but other than that I mean,
it's really hard to think of a way to kind
of control that situation.
- Right and at hospitals they do.
They have like a button or a pull string
that if you're feeling unsafe
that you can pull that and it alerts an alarm
like a blinking alarm on the door,
and then of course we have keys that we can get in there,
but I mean other than walking your patient
to the restroom and just knowing
that they're in there and just having
an understanding of like potentially
how long they've been in there
and kind of checking up on them.
Those are just things that
we could do if we didn't have an alarm system.
I suppose one of the things that we could potentially
start doing is, if we have patients
that have history of like dizziness and stuff,
just make sure that we stand them up,
ask them if they're dizzy
or if they're feeling unsteady
and if that's the case,
we probably should just sit them back down
and they can use the washroom when that passes.
This particular individual
had had those episodes in the past
and there's no way of knowing
when those are gonna happen.
He could have gone to the washroom
had no dizziness or lightheadedness
until he stood up from the toilet
if that's what he did.
So it's like you can run these scenarios in your head
to think about what all you could have done
to prevent it or how we can be more prepared for that
and one of the things that I think about is
is having like a defibrillator there
if a lot of places out in the public theaters
and restaurants usually have those kits around,
and that's probably something that we could consider
in the future. - I also think that staff
protective standpoint, we should probably be,
probably have you know where if you have
to give mouth-to-mouth resuscitation,
I mean there's more safe ways to do that
rather than just especially right now with COVID going on,
it gets even a little more scary.
- Yeah and part of me thinks like oh well we could
have our staff trained in CPR.
Maybe we can even call the local fire department
and have them come and just do some like lunch trainings
on first aid and those types of things
just so that we're a little bit more prepared.
I mean I'm prepared for that kind of stuff but--
- Yeah things happened to not be in the office one day,
and like the protocol right now is like if anything
medically happens, we just like where's Ashley,
because she's very specifically trained for that.
It's been a long time since I've been in the Marine Corps
like we were more like severe trauma trained.
If someone gets shot and things like that.
Charlie wants to make some noise again.
Come here puppy, come here, okay.
So but at the end of the day,
he ended up being fine.
We kind of ended the appointment at that point of course.
We had, what was that?
The EMTs came and-
- Yeah the paramedics came.
- Paramedics yeah.
- Fire department, you know, they did their
normal routine stuff.
They checked his blood sugar and EKG rhythm
and blood pressure and all that stuff,
but the highest risk or the highest thing
of importance at that time was that this individual
was on a blood thinner and he had fallen.
- Yeah we don't know internally bleeding wise too.
- Yeah you can't always see when there's internal bleeding
going on, so he just wanted to get that checked out
and I would have.
- Well they went to the emergency room for six hours
and then finally released him.
We had contact.
We had contacted them the day after it happened,
and he was fine.
So thank goodness I kind of feel like bullet
was dodged by him.
I can't help but feel really responsible for that.
I mean you can always look back in hindsight
and be like "Oh yeah I mean I should have stayed there
and watched him make his way to the restroom"
which seems kind of odd.
- Well-
- But like you try to think of things like
how could you have prevented that in the future,
and I don't think you're ever gonna prevent any
or every single- - No, no.
- Thing like that,
but then how do we change things to make sure that
if it does happen again that we're more prepared
to handle the outcome of that.
- Right I think in a hospital setting,
when my patient wants to use the washroom,
I walk them to the washroom.
That's just what we do
and I guess technically we could institute
that as well at our practice.
It's just hard to say
because like some patients might think,
"Oh he's just gonna walk me to the washroom I guess today."
- So it can be weird. - Some people that are very
potentially independent and don't rely
on a lot of help, might find yeah that behavior
of us walking them to the washroom a little bizarre.
So I don't know.
I think as long as you ask them if they stand up
and are they feeling okay?
You're not dizzy or lightheaded.
- And I think that's probably the question is that
we need to ask them
if they have had any kind of medical history
or whatsoever heart-related whatever,
to ask them are you feeling light-headed
as soon as we stand up and we're getting ready
to enter the booth.
- Quite frankly you could even ask your patient,
like "I'm happy to walk to the washroom
just to make sure that you don't get dizzy or lightheaded"
or if they have that history of being dizzy,
when they stand up, because I mean unless
this was the first time occurrence,
which it wasn't the first time this had happened
with this gentleman.
He had experienced episodes of-
- Yeah he had mentioned that- - Dizziness
and lightheadedness. - He would feel little bit
lightheaded when standing up.
But he'd never reported actually falling before,
but now he has to, so (speech drowns out speaker).
- There's a lot of factors involved in this,
like it's really hot right now.
The only thing he had had to drink was coffee,
so I mean there's just a lot of factors
that could have played into
why he was a little lightheaded
and kind of off-kilter when he was walking to the washroom.
Luckily and thankfully,
no serious injuries. - Everything was fine.
Yeah for sure.
So well I mean quite an eventful week for us.
Hopefully, we don't have to do a video like this ever again
but just want to make sure that you guys are aware
that when you have a hearing loss,
it does put you at more risk for falling,
and you really have to take this stuff into consideration
in terms of protecting yourself,
if you feel like you are at a higher risk,
you got to make sure that you let people know
and you have to have an emergency kind of like checklist
in place for if you do end up falling.
And like I said there are actual hearing aids
which is crazy to think about
that can, if you fall they have motion sensors in them
that can send a notification through your smart device
to family members or a caregiver,
so they can come in and check on you,
and I've actually heard stories of people's lives
being saved because
of that technology- - It's crazy.
- Which is absolutely crazy, but nonetheless,
that is it for this week's vlog.
Make sure you check out the other vlogs
on my youtube channel DrCliffAuD
and as always we'll see you next week.
(upbeat music)