{"id":5556,"date":"2020-05-27T09:50:13","date_gmt":"2020-05-27T13:50:13","guid":{"rendered":"http:\/\/199.83.241.179\/prevention-des-chutes\/prevention-des-chutes-pour-les-professionnels-de-la-sante\/evaluation-rapide-du-risque-de-chutes\/"},"modified":"2020-08-12T14:53:02","modified_gmt":"2020-08-12T18:53:02","slug":"evaluation-rapide-du-risque-de-chutes","status":"publish","type":"page","link":"https:\/\/rgpeoarchive.marketaccess.ca\/fr\/prevention-des-chutes\/prevention-des-chutes-pour-les-professionnels-de-la-sante\/evaluation-rapide-du-risque-de-chutes\/","title":{"rendered":"\u00c9valuation rapide du risque de chutes"},"content":{"rendered":"
[vc_row row_height_percent=\u00a0\u00bb0″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ column_width_use_pixel=\u00a0\u00bbyes\u00a0\u00bb shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ row_name=\u00a0\u00bbPostural Hypotension\u00a0\u00bb column_width_pixel=\u00a0\u00bb1000″][vc_column column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb2″ overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/1″][vc_column_text]\n

Survol des m\u00e9thodes utilis\u00e9es par les professionnels de la sant\u00e9 pour faire des \u00e9valuations et prendre des d\u00e9cisions li\u00e9es aux principales causes de chutes chez les patients a\u00een\u00e9s<\/p>\n[\/vc_column_text][vc_row_inner row_inner_height_percent=\u00a0\u00bb0″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb2″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ el_class=\u00a0\u00bbbuttons-equal\u00a0\u00bb][vc_column_inner column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/3″][vc_button button_color=\u00a0\u00bbcolor-blue\u00a0\u00bb size=\u00a0\u00bbbtn-lg\u00a0\u00bb wide=\u00a0\u00bbyes\u00a0\u00bb border_width=\u00a0\u00bb0″ link=\u00a0\u00bburl:%23postural-hypotension|\u00a0\u00bb]1.\u00a0\u00a0\u00a0\u00a0 hypotension orthostatique[\/vc_button][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/3″][vc_button button_color=\u00a0\u00bbcolor-blue\u00a0\u00bb size=\u00a0\u00bbbtn-lg\u00a0\u00bb wide=\u00a0\u00bbyes\u00a0\u00bb border_width=\u00a0\u00bb0″ link=\u00a0\u00bburl:%23pills|\u00a0\u00bb]M\u00c9DICAMENTS[\/vc_button][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/3″][vc_button button_color=\u00a0\u00bbcolor-blue\u00a0\u00bb size=\u00a0\u00bbbtn-lg\u00a0\u00bb wide=\u00a0\u00bbyes\u00a0\u00bb border_width=\u00a0\u00bb0″ link=\u00a0\u00bburl:%23pain-and-mobility|\u00a0\u00bb]Douleur et Mobilit\u00e9[\/vc_button][\/vc_column_inner][\/vc_row_inner][vc_column_text]Trois facteurs principaux, seuls ou conjugu\u00e9s, peuvent nuire de fa\u00e7on significative \u00e0 la qualit\u00e9 de vie des patients \u00e2g\u00e9s. Ces facteurs augmentent le risque d\u2019hospitalisation et de recours aux soins de longue dur\u00e9e, en raison de chutes graves.[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=\u00a0\u00bb0″ override_padding=\u00a0\u00bbyes\u00a0\u00bb h_padding=\u00a0\u00bb2″ top_padding=\u00a0\u00bb3″ bottom_padding=\u00a0\u00bb3″ back_color=\u00a0\u00bbcolor-817364″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ column_width_percent=\u00a0\u00bb100″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ row_name=\u00a0\u00bbPostural Hypotension\u00a0\u00bb][vc_column column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][vc_custom_heading]Les chutes sont la principale cause de blessures chez les a\u00een\u00e9s.[\/vc_custom_heading][vc_row_inner row_inner_height_percent=\u00a0\u00bb0″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″][vc_column_inner column_width_percent=\u00a0\u00bb100″ position_vertical=\u00a0\u00bbbottom\u00a0\u00bb gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][uncode_counter value=\u00a0\u00bb33″ size=\u00a0\u00bbh2″ text=\u00a0\u00bbChaque ann\u00e9e, 33 % des a\u00een\u00e9s font une chute pouvant entra\u00eener des cons\u00e9quences physiques et psychologiques, incluant l\u2019incapacit\u00e9, la douleur chronique, la perte d\u2019autonomie, la \u00a0\u00bb suffix=\u00a0\u00bb%\u00a0\u00bb][\/vc_column_inner][vc_column_inner column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][uncode_counter value=\u00a0\u00bb8″ text=\u00a0\u00bbdes hospitalisations en raison d\u2019une chute m\u00e8nent \u00e0 un d\u00e9c\u00e8s\u00a0\u00bb suffix=\u00a0\u00bb%\u00a0\u00bb][\/vc_column_inner][\/vc_row_inner][vc_row_inner row_inner_height_percent=\u00a0\u00bb0″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″][vc_column_inner column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][uncode_counter value=\u00a0\u00bb235,355″ text=\u00a0\u00bbVisites \u00e0 l\u2019Urgence et hospitalisations en raison d\u2019une chute au Canada en 2012-2013″][\/vc_column_inner][vc_column_inner column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][uncode_counter value=\u00a0\u00bb84,828″ text=\u00a0\u00bbHospitalisations en raison d\u2019une chute au Canada en 2012-2013″][\/vc_column_inner][\/vc_row_inner][\/vc_column][vc_column column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ style=\u00a0\u00bbdark\u00a0\u00bb overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][vc_custom_heading]M\u00e9dicaments qui augmentent le risque de chutes chez les a\u00een\u00e9S[\/vc_custom_heading][vc_progress_bar values=\u00a0\u00bb%5B%7B%22label%22%3A%22Diuretics%22%2C%22value%22%3A%227%22%2C%22bar_color%22%3A%22color-green%22%7D%2C%7B%22label%22%3A%22Anti-inflammatory%20drugs%22%2C%22value%22%3A%2221%22%2C%22bar_color%22%3A%22color-198639%22%7D%2C%7B%22label%22%3A%22Blood%20pressure%20medication%22%2C%22value%22%3A%2224%22%2C%22bar_color%22%3A%22color-green%22%7D%2C%7B%22label%22%3A%22Sleeping%20pills%20(benzodiazepines)%22%2C%22value%22%3A%2247%22%2C%22bar_color%22%3A%22color-198639%22%7D%2C%7B%22label%22%3A%22Antipsychotics%22%2C%22value%22%3A%2259%22%2C%22bar_color%22%3A%22color-green%22%7D%2C%7B%22label%22%3A%22Antidepressants%22%2C%22value%22%3A%2268%22%2C%22bar_color%22%3A%22color-198639%22%7D%2C%7B%22label%22%3A%22Opioid%20painkillers%22%2C%22value%22%3A%2268%22%2C%22bar_color%22%3A%22color-green%22%7D%5D\u00a0\u00bb units=\u00a0\u00bb%\u00a0\u00bb][vc_column_text el_class=\u00a0\u00bbtext-small\u00a0\u00bb]Sources: Canadian Frailty Network<\/a>,\u00a0 de Jong et al. 2013<\/a>, Huang et al. 2012<\/a>, Kelly et al. 2003<\/a>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\u00a0\u00bb1\/1″][vc_separator sep_color=\u00a0\u00bbcolor-green\u00a0\u00bb][\/vc_column][\/vc_row][vc_row row_height_percent=\u00a0\u00bb0″ override_padding=\u00a0\u00bbyes\u00a0\u00bb h_padding=\u00a0\u00bb2″ top_padding=\u00a0\u00bb3″ bottom_padding=\u00a0\u00bb3″ back_color=\u00a0\u00bbcolor-190038″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ column_width_percent=\u00a0\u00bb100″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ row_name=\u00a0\u00bbPostural Hypotension\u00a0\u00bb][vc_column column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/1″][vc_row_inner][vc_column_inner column_width_percent=\u00a0\u00bb100″ gutter_size=\u00a0\u00bb3″ overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/2″][vc_custom_heading]hypotension orthostatique[\/vc_custom_heading][vc_column_text text_lead=\u00a0\u00bbyes\u00a0\u00bb]Baisse soudaine de la tension art\u00e9rielle lorsqu\u2019une personne assise ou couch\u00e9e se l\u00e8ve.[\/vc_column_text][\/vc_column_inner][vc_column_inner column_width_percent=\u00a0\u00bb100″ position_vertical=\u00a0\u00bbbottom\u00a0\u00bb gutter_size=\u00a0\u00bb3″ overlay_alpha=\u00a0\u00bb50″ shift_x=\u00a0\u00bb0″ shift_y=\u00a0\u00bb0″ shift_y_down=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ medium_width=\u00a0\u00bb0″ mobile_width=\u00a0\u00bb0″ width=\u00a0\u00bb1\/4″][uncode_counter value=\u00a0\u00bb25″ counter_color=\u00a0\u00bbcolor-blue\u00a0\u00bb size=\u00a0\u00bbh1″ text=\u00a0\u00bb\u00c0 l\u2019\u00e2ge de 65 ans, une personne sur quatre aurait des sympt\u00f4mes d\u2019hypotension orthostatique.\u00a0\u00bb suffix=\u00a0\u00bb%\u00a0\u00bb][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/4″][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\u00a0\u00bb1\/2″][vc_column_text]\n

D\u00e9pistage et \u00e9valuation<\/h3>\n
    \n
  1. Mesurer la tension art\u00e9rielle<\/a> en position couch\u00e9e, assise et debout. Valeurs cibles pour les a\u00een\u00e9s: pression systolique<\/a> \u02c2 140 mmHg (cote C) pression diastolique \u02c2 90 mmHg (cote A)<\/li>\n
  2. Examiner les m\u00e9dicaments<\/a> qui pourraient contribuer \u00e0 l\u2019hypotension orthostatique (p. ex. antihypertenseurs, anticholinergiques, analg\u00e9siques).<\/li>\n<\/ol>\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/2″][vc_column_text]\n

    Intervention<\/h3>\n
      \n
    1. Ajuster les m\u00e9dicaments au besoin (p. ex. \u00e9liminer, r\u00e9duire la dose ou changer la fr\u00e9quence).<\/li>\n
    2. Traiter les causes<\/a> sous-jacentes de l\u2019hypotension orthostatique.<\/li>\n
    3. Renseigner le patient sur les strat\u00e9gies comportementales<\/a> et non pharmacologiques et l\u2019exercice.<\/li>\n
    4. Ressources sur l\u2019hypotension orthostatique: www.posturalhypotension.ca<\/li>\n<\/ol>\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column width=\u00a0\u00bb1\/1″][vc_separator sep_color=\u00a0\u00bbcolor-green\u00a0\u00bb][\/vc_column][\/vc_row][vc_row row_height_percent=\u00a0\u00bb0″ override_padding=\u00a0\u00bbyes\u00a0\u00bb h_padding=\u00a0\u00bb2″ top_padding=\u00a0\u00bb3″ bottom_padding=\u00a0\u00bb3″ back_color=\u00a0\u00bbcolor-268099″ overlay_alpha=\u00a0\u00bb50″ gutter_size=\u00a0\u00bb3″ column_width_percent=\u00a0\u00bb100″ shift_y=\u00a0\u00bb0″ z_index=\u00a0\u00bb0″ row_name=\u00a0\u00bbPills\u00a0\u00bb][vc_column width=\u00a0\u00bb1\/1″][vc_custom_heading]M\u00c9DICAMENTS[\/vc_custom_heading][vc_column_text text_lead=\u00a0\u00bbyes\u00a0\u00bb]Le m\u00e9tabolisme change avec l\u2019\u00e2ge, alors les m\u00e9dicaments pr\u00e9sentent un risque \u00e9lev\u00e9 de causer des effets secondaires chez les a\u00een\u00e9s. L\u2019examen minutieux des m\u00e9dicaments et de leur effet sur le risque de chutes est un moyen de pr\u00e9vention efficace et proactif.[\/vc_column_text][vc_row_inner][vc_column_inner width=\u00a0\u00bb1\/2″][vc_column_text]\n

      d\u00e9pistage et \u00e9valuation<\/h3>\n
        \n
      1. Reconna\u00eetre les m\u00e9dicaments<\/a> associ\u00e9s \u00e0 un risque accru de chutes : psychotropes, m\u00e9dicaments cardiovasculaires, analg\u00e9siques, antidiab\u00e9tiques et anticonvulsivants.<\/li>\n
      2. Outils pour identifier les m\u00e9dicaments contre-indiqu\u00e9s chez les patients fragiles : crit\u00e8res de Beers<\/a> et crit\u00e8res STOPP<\/a>.<\/li>\n
      3. Calculatrice pour d\u00e9terminer la charge anticholinergique d\u2019un m\u00e9dicament<\/a>.<\/li>\n<\/ol>\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/2″][vc_column_text]\n

        Intervention<\/h3>\n

        Envisager la d\u00e9prescription<\/a> des m\u00e9dicaments qui causent les effets suivants:<\/p>\n