Introduction: Falls are a significant source of healthcare related morbidity and mortality of patients in hospitals and residential healthcare settings. Commonly falls are thought of as an affliction of the elderly and the frail. The emergency department (ED) is a unique healthcare setting that sees patients in the acute and hyper acute stages of physical and mental illness and intoxication. Falls occur in this setting, however there is little knowledge about the factors that influence falls in the emergency department.

Methods: This study was conducted in a large inner city, tertiary ED. Data was collected from the electronic incident management system for the period of time 2011–2015 and additional information was extracted from the patient's medical record.

Results: During the study period a total of 190 fall incidents at a fall rate of 0.63 falls per 1000 presentations. 95.7% of these falls resulted in no or minimal harm to the patient. Patients who fell in the emergency department were younger them previously identified in other settings. The use of high-risk medications, recreational substances and alcohol was prevalent throughout the ED falls population. The most likely time for a patient to fall was during mobilisation, especially to the bathroom.

Conclusion: Falls occur in all healthcare settings, which include the ED. The cohort that falls in the ED is younger then in other settings and is more likely to have ingested recreational substances such as alcohol. A rethinking of falls risk specific to the emergency department needs to occur, along with further research into ED related falls.