Elderly

Question 1

Why do elderly Pt have les physiological reserve?

Answer 1

• Ageing
• Co-morbidity
• Drug therapies they may be undertaking
• Reduced cardiac compensatory ability
• Reduced pulmonary compliance
• Reduced renal function
• Reduced ability to respond to fluid loss or gain

Question 2

What are complications of the elderly?

Answer 2

• Infections
• Respiratory
• Cardiac
• Renal

Question 3

What is the number one cause of trauma in the elderly?

Answer 3

• Falls

- Also have a high % of pedestrian trauma

Question 4

What are specific notes in regards to the head injured elderly patient?

Answer 4

• If PT GCS<11 associated with very poor Pt outcomes.

- Ethical considerations – in regards to continued aggressive management.

Question 5

What are specific notes in regards to thoracic and abdominal injuries.

Answer 5

• Greater suspicion should be held for rib fractures due to increased risk of osteoporosis
• > supportive mechanism in thoracic trauma due to cardio-respiratory reserve
• Will tolerate shock less well and will progress through the stages quicker.

Question 6

What specific injuries need to be considered in the elderly and frail?

Answer 6

-	Pelvis
o	Be aware of haemorrhage
o	Aggressive and early control
-	Spinal
o	More likely to occur from falls
o	Most common elderly C-spine C1-2
-	Fractures
o	Due to osteoporosis injury may not align with the mechanism
o	Neck of femur fractures
-	Penetrating
o	Most likely due to suicide or violence
-	Burns
o	Inability to tolerate rapid changes in fluid