Introduction to complex care and the injured patient Flashcards
What is trauma?
the transference of energy to the body
Types of trauma
Kinetic -
- Blunt - falls, motor vehicle accidents… - Penetrating - bullet wound, stabbing..
Chemical - chemical burn, deprivation of oxygen
Thermal - scalds, burns…
Radiation - UV burns…
Electrical - electrocution..
What is an epidemic?
an illness, injury or disease that affects a large number of the population in a region…with apparent growth
What is the main cause of injury-related hospital separations
falls
the aging process of the integumentary system
- epidermis flattening & loss of papillae -> decreased adhesion between layers
- loses elasticity
- loss of subcutaneous fat and wrinkling of the skin - skin can tear easily
- nails become thick and brittle
the aging process of the musculoskeletal system
- atrophy of tissue extends to muscle and bone
- decreased muscle strength and movement
- bone mass decreases -> brittle bones
what type of medications can make skin fragile
corticosteroids - prednisolone eg. for inflammatory conditions such as asthma
how to prevent musculoskeletal deterioration
weight-bearing exercises promote osteogenesis
Vit D
the aging process of the respiratory system
- Trachea and ribcage become less flexible
- # of alveoli reduces
- decreased arterial partial pressure of oxygen
the aging process of the circulatory system
- decreased contractility of the myocardium -> decreased CO
- vasculature thins and stiffens
` - Arrhythmias and conduction disturbances are more prevalent, harder to diagnose and are not tolerated well
What are the pts at risk of if they stay in pjs
pts are likely to become more immobile
- ^UTI risk
- low circulation
- ^ infection risk
- ^ PI risk
- atrophy
- DVT risk
the aging process of the renal system
- 20% smaller by 80yo
- decreased glomerular filtration rate ^ risk of AE and drug-induced renal failure
- increased risk of fluid overload - fluid resuscitation must be titrated to CV pressure and UO.
the aging process of the gastrointestinal system
- Gastric emptying, splenic blood flow, GI motility lower with age - ^risk of vomiting, constipation
- common Ed complaint- abdo pain
- mortality rate in an older person with abdo pain is 10x higher than in young people
Colles fracture - common trauma injury in an older person
- describe
- why is this injury complex
wrist fracture
- fall onto hand
- usually fractures both radius and ulna
- likeness of a dinner fork
- impacts mobility
- impacts independence
- pain
- opioids - consider liver/kidney function
- NSAID - stomach ulcers - stop production of
prostoglandin
what are the 2 most common trauma injuries for older people
Colles fracture (wrist)
fractured NOF
