What is the primary concern for an 87-year-old male on warfarin after experiencing a fall?

For an 87-year-old male on warfarin, the primary concern after experiencing a fall is the high risk of internal bleeding. Warfarin is an anticoagulant medication that increases the time it takes for blood to clot. This can lead to a greater likelihood of bleeding, particularly in fragile older adults who may have age-related changes in vasculature or bone density.

When a fall occurs, especially in older adults, there is a significant risk that the impact could cause internal injuries alongside any external injuries. Since the patient is on warfarin, the consequences of any internal bleeding would be exacerbated by the anticoagulant effect of the medication, potentially leading to severe complications such as a hematoma, intracranial bleed, or other internal organ bleeding that might go undetected until it's serious.

While the potential for broken bones is a valid concern and common in falls among the elderly, the immediate and critical concern following a fall in a patient on warfarin leans more heavily towards the risk of internal bleeding due to the medication's effect on clotting mechanisms. Other issues such as infection risk and dehydration, while relevant in the context of patient care, are not as immediately concerning in the event of an acute fall with this medication background