MOD E Tech Trauma in the Elderly Flashcards
Trauma in the Elderly
Fatal outcomes more likely,
even if injury is
relatively low in severity.
Trauma in Elderly
Age impairs body’s response.
Age impairs body’s response.
Trauma is major cause of death.
- Falls
- Fractures of hip, femur, wrist, and head injuries
- Motor-vehicle collisions
- Higher incidence of collision
- Thermal injury
- Inhalation, scalding, flame burns, electrical injury
Trauma in Elderly
Higher risk of injury
Higher risk of injury
- Reflex response time increased
- Eyesight and peripheral vision decreased
- Hearing decreased
- Postural instability
- Arthritis
- Fragile skin and blood vessels
- Fragile bones
Respiratory System
The Aging Body
Cardiovascular system
- Congestive heart failure and pulmonary oedema
- Circulation decreased
- Cardiac output and stroke volume decreased
- Conduction system degenerates - fibrosis
- Heart valve efficiency decreased
- Arteriosclerosis
- Peripheral vascular resistance increased
- Systolic hypertension
Neurological and sensory function
- Subdural hematoma
- Brain shrinks, dura mater adherent to skull
- Brain arteries harden, narrow, lose elasticity
- Unrecognized injury
- Blood flow to brain decreased
- Sensory responses decreased
- Pain tolerance increased
- Altered mental status
- Blood flow to brain decreased
Thermoregulation
- Hypothermia
- Temperature control mechanism deteriorates
- Subcutaneous tissue decreased
- Afebrile with infection
- Temperature control mechanism deteriorates
The Aging Body
Musculoskeletal system
•
Musculoskeletal system
- Postural changes
- Kyphotic deformity of spine
- Slight flexion of knees and hips
- Muscle strength decreased
- Fractures
- Advanced osteoporosis
- Bone density decreased
- Subcutaneous tissue decreased
The Aging Body
Gastrointestinal system
Overall system changes
Gastrointestinal system
- Malnutrition
- Decreased ability to metabolise medications
Overall system changes
- Prolonged illness and recovery time
- Decreased total body water leads to dehydration
Medications
Drug interaction problems
- Anticoagulants increase bleeding time
- Antihypertensives and peripheral vasodilators limit constriction response
- Beta-blockers limit tachycardia response
Important Points
General organ systems less effective.
•Especially cardiovascular, pulmonary, renal
Chronic illness complicates trauma care.
•Difficult to distinguish
Bones fracture more easily.
•Major bone fractures can be life-threatening
Patient Assessment
Primary and Secondary Surveys
Anticipate complicating factors
- Peripheral pulses difficult to evaluate
- Many layers of clothing
- Chronic disease vs. acute problem
- Nonpathologic rales
- Loss of skin elasticity and mouth breathing
- Dependent oedema
- Variation in normal vital signs
Scene Size-up
Verify history with reliable bystander.
Observe surrounding area.
- Indications that unable to provide own care
- Alcohol or medication abuse
- Signs of violence, abuse, neglect
- Notify proper authorities – Safeguarding referral
Gather medications and take to hospital.
Initial Assessment
Initial level of consciousness
- Clarify normal level before trauma
- Preexisting condition or trauma
- Check blood glucose
Chest injuries
•More likely serious
Spinal precautions
•Arthritis and kyphosis
Ongoing Exam
Monitor IV fluid administration response.
•May precipitate congestive heart failure
Frequently assess pulmonary status.
- Lung sounds
- Cardiac monitoring
- Pulse oximetry
Capnography
Summary
Increasing number of elderly patients
Evaluation and treatment more difficult
- Physiologic processes of aging
- Frequent concurrent illnesses
- Medication effects
Limited compensation mechanisms
•Respiratory and circulatory support essential
