A SPLATT analysis is a structured method healthcare providers use to gather detailed information about a fall. It’s a mnemonic, with each letter representing a specific question to ask after someone (usually an older adult) has fallen: Symptoms, Previous falls, Location, Activity, Time, and Trauma. The purpose is to move beyond “I fell” and uncover patterns that reveal why the fall happened and how to prevent the next one.
What Each Letter Stands For
The SPLATT mnemonic breaks a fall into six categories of information:
- Symptoms: Any symptoms the person experienced before or during the fall, such as dizziness, lightheadedness, or blurred vision.
- Previous falls: Whether the person has fallen before, had near-falls, or developed a fear of falling.
- Location: Where the fall happened, which helps identify environmental factors like poor lighting, uneven surfaces, or tripping hazards.
- Activity: What the person was doing right before the fall, such as turning, standing up from a chair, or walking in a crowd.
- Time: When during the day the fall occurred, since timing can point to specific causes.
- Trauma: What happened during and after the fall, including how the person landed, whether they lost consciousness, and how long they stayed on the ground.
Some versions use one T instead of two, dropping the Trauma category or combining it with another element. Both SPLAT and SPLATT appear in clinical literature, and they serve the same basic function.
How It Helps Identify the Cause of a Fall
Falls in older adults rarely have a single, obvious cause. A SPLATT analysis pieces together the circumstances so that a pattern emerges. The location and activity questions help separate environmental causes (a loose rug, a dark staircase) from medical ones (a blood pressure drop, a medication side effect). If someone consistently falls in the morning right after standing up, that points toward orthostatic hypotension, where blood pressure drops suddenly when changing position. Falls later in the day may suggest fatigue or medication timing issues.
The symptoms question is especially important for distinguishing a simple trip from something more serious. Feeling lightheaded or “blacking out” before a fall could indicate a heart rhythm problem or a drop in blood sugar. A fall with no warning symptoms during a routine activity like walking on flat ground raises different concerns than one that happened while rushing down wet steps.
Previous falls matter because a single fall might be an isolated accident, but a pattern of repeated falls signals an underlying issue that needs investigation. Fear of falling also matters: people who are afraid of falling often restrict their activity, which weakens their muscles over time and actually increases their risk.
What Happens Before, During, and After
Clinicians using the SPLATT framework organize the information into three phases. The pre-fall phase covers activity and symptoms, establishing what was happening in the moments leading up to the fall. The during-the-fall phase captures how the person went down, which direction they fell, and how they landed. This matters both for identifying injuries and for understanding mechanics. Someone whose legs buckled has a different problem than someone who tripped over a threshold.
The post-fall phase looks at what happened afterward. Did the person lose consciousness, even briefly? Were they drowsy or confused? Did they lie on the ground for more than an hour before getting help? A long lie (being stuck on the ground) is a serious concern on its own, since it can lead to dehydration, pressure injuries, and muscle breakdown, and it often signals that the person lives alone or couldn’t physically get up.
How It Shapes Prevention
The real value of a SPLATT analysis is that it points directly toward specific interventions. Research published in Age and Ageing found that individual SPLATT analyses can support the design of falls prevention plans tailored to a person’s specific needs and history, rather than relying on generic advice.
If the analysis reveals that someone keeps falling in the bathroom at night, the response might focus on better lighting, grab bars, and a bedside commode. If it shows falls consistently happen after standing up quickly, the focus shifts to checking medications that lower blood pressure and practicing safe ways to transition from sitting to standing. If there’s a pattern of tripping during walks outside, the intervention might involve gait training, footwear changes, or strength exercises targeting the legs and ankles.
This specificity is what separates SPLATT from broader fall risk screening tools. Programs like the CDC’s STEADI initiative use algorithms and physical tests to estimate a person’s overall fall risk. A SPLATT analysis does something different: it reconstructs what actually happened during a specific fall to extract actionable details. The two approaches complement each other. Screening identifies who is at risk, while SPLATT helps explain why a fall occurred and what to do about it.
Who Uses It and When
SPLATT is used across a range of healthcare settings, from primary care offices and emergency departments to rehabilitation facilities and community fall prevention programs. Physicians, nurses, physiotherapists, and occupational therapists all use some version of it. It’s particularly common in geriatric care, where falls are a leading cause of injury and hospitalization.
The analysis is typically done as a conversation. A clinician walks through the mnemonic with the patient (or a family member who witnessed the fall), asking targeted questions about each element. It doesn’t require any equipment or special training, which makes it easy to use in virtually any setting. For people who have fallen multiple times, running through the SPLATT questions for each fall can reveal recurring themes that a single assessment might miss.