A Hand Raised for Help: Geriatric “Lift-Assist” Emergency Medical Calls as a Marker of Need for Early Intervention
Emily A. Moore1, Carlo L. Rosen1, Shan W. Liu2, Stephen H. Thomas1,3, Matthew J. Bivens 1
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA
2Department of Emergency Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA
3Blizard Institute, Barts & The London School of Medicine, London, UK
Background
Geriatric patients who have fallen often call emergency medical services (EMS) for assistance back to their feet but then, once so assisted, refuse transport to the hospital. In this study, these incidents of geriatric fall with refusal of transport are referred to as a “lift-assist”.
Methods
A year’s worth of a single urban EMS service’s records was reviewed to identify cases where a patient refused transport after a fall and was at least 65 years old.
Results
More than 19,000 calls were reviewed, of which 7,329 were for patients at least 65 years old.
Of these, 433 involved a fall with a refusal of transport. Of these, nearly a third (142, or 32.8%) involved a repeat EMS call within 30 days, which usually resulted in transport to the ED (71.1%) and often in a hospitalization (42.3%).
Conclusion
The literature, including our own recent review of the records of an urban EMS system in Massachusetts, suggests many of these patients need more than a helping hand to stand, and would benefit from immediate or near-term follow-up for medical and /or rehabilitation care.
DOI: 10.29245/2767-5122/2026/4.1177 View / Download PdfBeyond Volume: A Pathophysiology-Driven Approach to Evaluating Physical Treatments for Oedema of Lymphatic Origin — Reflections of the Belgian Society of Lymphology
DOI: 10.29245/2767-5122/2026/3.1174 View / Download PdfBourgeois Pierre*1, Adriaenssens Nele*2,3, Barbieux Romain4, Roman Mirela M5, Harfouche Joseph6, Leduc Olivier4
1Services of Dermatology and Vascular Surgery, Erasme and HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium.
2Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium.
3Medical Oncology Department, Universitair Ziekenhuis Brussel, Brussels, Belgium.
4Lympho-Phlebology Unit, Department of Occupational and Environmental Physiology, Haute Ecole HE2B ISEK, Brussels, Belgium.
5Department of Mammo-Pelvic Surgery, CHU St Pierre, Université Libre de Bruxelles, Brussels, Belgium.
6Department of Physical Therapy, Delta Hospitals, Brussels, Belgium
Know Thy Limits: Calibrated Uncertainty for Safer Rehabilitation
Joel Strickland
Intellegens, The Studio, Chesterton Mill, Cambridge, UK
Rehabilitation clinicians make threshold-based decisions—exercise progression, return-to-work clearance, heat safety management—that depend on reliable physiological monitoring. Yet current noninvasive methods for estimating core body temperature provide only point predictions with no indication of reliability. A prediction of 38.3°C tells clinicians nothing about whether the true value is 38.2°C or 39.0°C, making it impossible to distinguish a trustworthy estimate from a dangerously uncertain one. This limitation is especially concerning in rehabilitation, where autonomic dysfunction, cardiovascular medications, and atypical physiology cause prediction errors to vary unpredictably across patients and conditions. This mini-review argues that calibrated uncertainty—not accuracy alone—should be a foundational requirement for physiological monitoring in rehabilitation. It introduces conformal prediction, a framework that produces statistically valid prediction intervals: when configured for 95% confidence, the true temperature falls within the stated bounds approximately 95% of the time. Proof-of-concept evidence spanning over 140,000 measurements across six high-heat operational domains demonstrates that such calibration is technically achievable in real-world settings. For rehabilitation practice, uncertainty-aware monitoring enables risk-stratified exercise progression, defensible return-to-work decisions grounded in explicit confidence bounds, and scalable telemonitoring with transparent escalation pathways. The central principle is that uncertainty should be treated as a first-class clinical signal—used to pace progression, trigger conservative action, and distinguish high-risk physiology from low-trust measurement.
DOI: 10.29245/2767-5122/2026/3.1173 View / Download Pdf