It’s not something you really think about until you’re a nurse or a doctor.

And yet, it happens with alarming regularity – people dying, or being seriously injured, from accidental falls as they go about their day-to-day lives.

A home handyman falling off a ladder. A tourist falling off an e-scooter. A drinker falling over intoxicated or off a balcony. A shopper tripping while distracted by a mobile phone. Tradies falling on construction sites. The elderly falling over in their homes. People of all ages falling because of a medical issue.

No matter the mechanism, the biggest problem that falls collectively have is the potential for life-threatening head and spinal injuries.

You don’t have to fall far to wind up in ICU fighting for your life. I have seen people with serious injuries caused by falls from a standing height.

Every now and then, a high-profile case brings it into the spotlight – most recently One Direction singer Liam Payne dying from a balcony fall, the cause of which is still being investigated. Yet we move on as quick as the news cycle without really considering how easily a fall could impact our own lives and families.

Data from the Australian Institute of Health and Welfare reveals the severity of the problem.

The 2023 report on Injury in Australia found that falls are the leading cause of hospitalisation from an injury and the leading cause of death from an injury.

More than 230,000 people were hospitalised because of falls in 2021/22 and 5800 people died from their injuries. That’s more than 600 hospitalisations and 15 deaths every single day.

Unsurprisingly, the main site of injury was head and neck (28%), followed by leg and hip (27%), arm and shoulder (23%), trunk (15%) and ankle, foot, wrist and hand (7%).

Neurosurgeons do astonishing things to save people’s lives. They perform emergency surgeries to fix brain haemorrhages and craniectomies to remove part of a person’s skull to alleviate swelling and pressure. They operate on people’s spines to protect them from spinal cord injuries.

Patients come from the operating room to ICU with surgical drains and devices that have been inserted into their brains, such as an EVD (external ventricular drain) to slowly remove cerebrospinal fluid, and ICP monitoring (intracranial pressure) so that pressure inside the brain can be measured and managed.

Falls are a common cause of TBI (traumatic brain injury), such as that experienced by Formula One driver Michael Schumaker from a skiing accident.

TBIs cause a complex web of primary and secondary injuries, leading to long ICU admissions and protracted rehabilitation, from which a full recovery is not always possible.

In Australia, falls from skis, skateboards, ice-skates and roller-skates accounted for 7890 hospitalisations in 2021-22, which is about 20 every day.

So the question is, what do we do about falls and their massive impact on population health and wellbeing? We can’t stop people from engaging in regular daily activities or enjoying pursuits they love.

The government and healthcare messaging focuses on community education and improved safety initiatives. For example, compulsory helmets on e-scooters with hefty fines for non-compliance, and falls prevention strategies in the home, particularly for the elderly.

And of course medical research continues to strive for new ways to treat traumatic injuries and improve long-term outcomes for patients.

The University of Melbourne has established a multi-disciplinary team to investigate a targeted treatment to stabilise brain injuries, protect neural function, and to remodel and repair the brain.

After some promising research with animal models, which showed decreased brain inflammation and improved motor function, researchers expect to progress to Phase 1 clinical trials within five years.

Useful links on falls:
Ladder safety: Ladder safety matters – Better Health Channel
Scooters and child safety: Scooters and child safety – Better Health Channel
Preventing falls at home: Preventing falls at home – Better Health Channel
Farm safety: Farm safety – falls – Better Health Channel

Sources:
Injury in Australia: Falls – Australian Institute of Health and Welfare (aihw.gov.au)
Rise in e-scooter-related brain injuries highlights the need for new treatments | Pursuit by the University of Melbourne