Week 3 Geriatric patients - trauma

Question 1

what are some stats about geriatric trauma?

Answer 1

5 times more likley to die
1/5 falls causes serious injuries
>95% NOF caused by fall
25% of geriatric NOF die within a year

Question 2

why are geriatric paitents at increased risk of trauma?

Answer 2

Skeletal abnormalities
unsteady gait
slowed reaction time
cognitive imparemtns
change in eyesight
changes in hearing

Question 3

what CNS changes impact on traumatic head injury in geriatric paitents?

Answer 3

Ageing brain more suceptible to shearing forces, axional injuries and heamotoma
- decreassed elasticity of bridging veins lining the meningies
- decreased number of neurons and functions
decreased brain mass and increased realtive intracranial space

Question 4

how much weight does the brain shrink when we age?

Answer 4

10-20% by age of 80

Question 5

what impact do skin changes have on trauma?

Answer 5

increased of full thickness injury - due to more fragile skin, less elsatin and structual support

Question 6

what considerations impact on geriatric trauma in realtion to cardic changes?

Answer 6

> 50% hypertnesion
30% heart diseas- beta blockers or anticoagulatons- mortality 5/10% higher
increased bleeding risk if patient taking blood thinners- asprins, cloidogerl, warfin, apixaban, dabigatran, rivaroxaban

Question 7

what neurological things can impact on geriatric paitents risk for trauma?

Answer 7

mental staus
cognitive changes - deafness, eye sight
confusion, acute or chronic
medications

Question 8

what are the differntial Dianoses for geriatric falls?

Answer 8

Accidents- slips, trips
syncope, dizziness virtigo
orthostatic hypotension
hypovolemia or low CO
drugs, medications
Acute ilness
CVS- arythmias, heat disease
Neuro- stroke, seizure

Question 9

what are the intrinsic factors that can play a role in geriatric falls?

Answer 9

Intrinsic- age realted decline infucntion, medical conditions, psychoatric conditions, relfexes, gait

Question 10

what are the extrinsic factors that can play a role in falls?

Answer 10

medications, unsafe footware, poorly fitted assitance devices, environmental hazzards

Question 11

what is the best predicotror for a future fall?

Answer 11

2 or more falls in the past 12 months

Question 12

What is osteoporosis?

Answer 12

progresive loss of bone mass
distruption of normal bone remodelling- bone reabsorbtion is greater than bone sunthesis

1/3 women over 50

Question 13

what are the risk factors for osteoporosis?

Answer 13

female, previous fratality, current smoker, EATOH

Glucocorticosteriods, low calcium, low BMI

Question 14

what may osteoporsis be secondary to?

Answer 14

hyperthyroidisim
premature menapoause
chronic malnutrition, malabsorption
chronic liver disease