Geriatric Trauma

Question 1

What are 5 preexisting conditions that influence outcomes in trauma patients?

Answer 1

1. Cirrhosis
2. Coagulopathy
3. COPD
4. Ischemic heart disease
5. Diabetes

Question 2

What are risk factors for falls in a geriatric patient?

Answer 2

1. Previous fall
2. Advanced age
3. Physical impairments
4. Medication use
5. Dementia
6. Unsteady gait
7. Visual, cognitive, neurological impairments

Question 3

What are unique challenges to airway management in a geriatric patient?

Answer 3

1. Loss of protective airway reflexes
2. Dentures can obstruct the airway - if they’re not obstructing the airway, then can leave them on during bag-mask ventilation since this can improve mask fit
3. Arthritic changes can make mouth opening and C spine management more difficult

Question 4

Why are elderly trauma patients at higher risk for respiratory failure?

Answer 4

Lower compliance of lungs and chest wall

• also have a suppressed heart rate response to hypoxia so respiratory failure may be more insidious in older adults
• increased kyphoscoliosis, decreased gas exchange, decreased mucociliary clearance from airways

Question 5

What are two factors that place the elderly individual at higher risk for intracranial hemorrhage with trauma?

Answer 5

1. Use of anticoagulant and antiplatelet medications

2. Dura becomes more adherent to the skull with aging so higher risk of epidural hematoma with injury

Question 6

What is the most common complication of rib fractures in the elderly?

Answer 6

Pneumonia