Surgery in older people Flashcards
What makes a patient high risk for surgery?
How much does o2 consumption increase to post operatively?
Reduced cardiac and vascular compliance and autonomic dystrophy complicates what?
Fluid management
Altered thermoregulation increases the risk of what?
Perioperative hypothermia
Chest wall rigidity and changed to lung function reduces what?
Reduces pulmonary reserves and predispose to pneumonia
Altered kidney and hepatic function lead to disorders of what?
Electrolytes and alter the pharmacokinetics of drugs
What are the main predictors of surgical outcomes?
Physiological reserve/functional capacity is closely linked to what?
Frailty and sarcopenia
What is sarcopenia?
What are the five criteria for frailty?
Pre-existing dementia can increase risk of what?
Delirium
DM and renal disease are associated with a raised risk for what complications?
Cardiac
Vascular disease predicts likelihood of what after surgery?
MI or stroke
COPD, smoking, asthma and obesity increase the change of what complications?
Respiratory
What is malnutrition associated with?
Poor outcomes and poor wound healing
Poor aerobic conditioning is associated with increased what?
Cardiac risk
Sarcopenia affects what recovery?
Functional
What surgerys are high risk?
What surgeries are intermediate risk?
What surgeries are low risk?
What is ERAS?
Enhanced recovery after surgery
What is the DREAM acronym for post surgery?
How do you reduce surgical stress?
Why does laparoscopic surgery place stress on the respiratory system?
Do patients have oliguria post surgery?
what is the BRAN tool?
What is silver trauma?
What is the injury severity score?
Injury severity score of more than 15 = what?
What is the commonest injury seen in silver trauma?
TBI - Traumatic brain injury
What is the most common mechanism of injury for a silver trauma?
Fall <2m e.g. fall from standing
Do older patients present with the same GCS as a younger person with the same problem?
No, can be higher
Why do elderly patients present with higher GCS than younger?
Why are older patients more likely to have TBIs?
What is hypotension in silver trauma?
Are chest wall injuries e/g/ rib fracture always seen on chest xray?
What are the complications of rib injuries in older patients?
Which ribs make the greatest physiological significance?
Silver traumas signs for mechanism of injury?
silver trauma signs for physiology/anatomy?
