Prehospital Care of Older Adults Following Perceived Low-Acuity Falls and Related “Lift Assist” Encounters: An NAEMSP Position Statement and Resource Document

Older adults who present as low-acuity falls requiring mobilization assistance, commonly referred to as a "lift assist", represent a common reason for EMS activation. These encounters often involve underlying medical conditions or injuries that are not immediately apparent, and missed or delayed diagnosis is associated with adverse outcomes. At the same time, some patients are transported to the emergency department when it is not necessary, exposing them to potential harms and contributing to increased healthcare utilization. These encounters are therefore complex clinical presentations and represent important opportunities for thorough assessment and higher-order clinical decision making, supported by systems that enable appropriate disposition and follow-up. However, there is a system-level bias, beginning in initial education and reinforced through dispatch, policy, and protocol, that frames these encounters as uniformly low-acuity, non-medical, minor traumas leading to underassessment and limiting clinical decision-making. Therefore, NAEMSP recommends:EMS systems should recognize calls for falls or "lift assists" as patient encounters that warrant an assessment, including evaluation for underlying medical causes, traumatic injuries, and safety, and frame these encounters as opportunities for higher-order clinical decision-making within the broader context of geriatric syndromes rather than isolated low-acuity events.EMS systems should support transport decisions based on a thorough assessment and patient-centered discussion, recognizing that not all patients require ED transport and that safe alternatives may include non-transport or referral to appropriate follow-up pathways.EMS systems should track the assessment of patients encountered during "lift assist" responses and older adults following perceived low acuity falls as a system-level quality measure to monitor performance and drive improvement.Policymakers and payers should implement sustainable reimbursement structures that support EMS assessment and care even when transport does not occur.