True or false? Although the mechanism of injury may be similar to those for the younger
popula on, data shows increased mortality with similar severity of injury in older adults. -
correct answers True
In the elderly popula on, what is decreased physiological reserve? -correct answers aging is
characterized by impaired adap ve and homeosta c mechanisms that caused an increased
suscep bility to the stress of injury. Insults tolerated by the younger popula on can lead to
devasta ng results in elderly pa ents.
Pre-exis ng condi ons that affect morbidity and mortality include: -correct answers cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? -correct answers Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the most
common cause of TBI.
In the elderly popula on, what are risk factors for falls? -correct answers advanced age, physical
impairment, history of previous fall, medica on use, demen a, unsteady gait, and visual,
cogni ve impairment
Most of elderly traffic fatali es occur in the day me and on weekends and typically involve
other vehicles. Why? -correct answers Older people drive on more familiar roads and at lower
speeds and tend to drive during the day. Older people have slower reac on me, a larger blind
spot, limited cervical mobility, decreased hearing, and cogni ve impairment.
,True or False? Mortality associated with small to moderate sized burns in older adults remains
high -correct answers True
Spilled hot liquids on the leg, which in younger pa ents may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older pa ents. -correct answers this
is true
Airway-pa ents may have dentures that may loosen or obstruct the airway. If dentures are not
obstruc ng the airway, leave them in place for what? -correct answers bag mask ven la on, as
it improves mask fi ng.
When preforming rapid sequence intuba on, the dose of benzos, barbiturates, and other
seda ves should be reduced to what percentage to minimize the risk of cardiovascular
depression? -correct answers 20-40%
Func onal changes in cardiac system include declining func on, decreased sensi vity to
catecholamines, atherosclerosis of coronary vessels, increased a erload, fixed heart rate (beta
blockers) -correct answers this results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Func onal changes in pulmonary system include decreased elas c recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex -correct answers thus they are at
increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
Func onal changes in renal system include loss of renal mass, decreased GFR, and decreased
sensi vity to ADH and aldosterone -correct answers resul ng in drug dosing for renal
insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
, Func onal changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
car lage, c spine degenera ve changes and loss of skin elas n and subcutaneous fat -correct
answers resul ng in increased risk for fractures, decreased mobility, difficulty for oral
intuba on, risk of skin injury, increased risk for hypothermia, challenges in rehabilia on
Func onal changes in Endocrine system include decreased produc on and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) -correct answers resul ng in occult
hypothyroidism, rela ve hypercor sone states and increased risk of infec on
True or false: Arthri s can complicate the airway and cervical spine. Pa ents can have mul level
degenera ve changes affec ng disk spaces and posterior elements associated with severe
central canal stenosis, cord compression, and myelomalacia -correct answers true
In elderly popula on, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ven la on is okay. In addi on, because
aging causes a suppressed heart rate response to hypoxia...... -correct answers respiratory
failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma pa ent at significant
risk for being inaccurately categorized as hemodynamically stable. -correct answers Elderly
pa ents have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older pa ents have
HTN, an acceptable BP may truly reflect a hypotensive state. A systolic BP of 110 is to be u lized
as the threshold for iden fying hypotension in pa ents 65 and older.
Do no equate blood pressure with shock in older pa ents -correct answers BP in older pa ents
may look normal due to the medica ons they are on. Use lactate and base deficit to evaluate
for evidence of shock
what 2 factors place elderly pa ents at risk for intracranial hemorrhage? -correct answers aging
causes dura to become more adherent to the skull increasing risk of injury and older pa ents
are on an coagulant and an platelet medica ons.
popula on, data shows increased mortality with similar severity of injury in older adults. -
correct answers True
In the elderly popula on, what is decreased physiological reserve? -correct answers aging is
characterized by impaired adap ve and homeosta c mechanisms that caused an increased
suscep bility to the stress of injury. Insults tolerated by the younger popula on can lead to
devasta ng results in elderly pa ents.
Pre-exis ng condi ons that affect morbidity and mortality include: -correct answers cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? -correct answers Fall. Nonfatal
falls are common in women and fractures are common in women who fall. Falls are the most
common cause of TBI.
In the elderly popula on, what are risk factors for falls? -correct answers advanced age, physical
impairment, history of previous fall, medica on use, demen a, unsteady gait, and visual,
cogni ve impairment
Most of elderly traffic fatali es occur in the day me and on weekends and typically involve
other vehicles. Why? -correct answers Older people drive on more familiar roads and at lower
speeds and tend to drive during the day. Older people have slower reac on me, a larger blind
spot, limited cervical mobility, decreased hearing, and cogni ve impairment.
,True or False? Mortality associated with small to moderate sized burns in older adults remains
high -correct answers True
Spilled hot liquids on the leg, which in younger pa ents may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older pa ents. -correct answers this
is true
Airway-pa ents may have dentures that may loosen or obstruct the airway. If dentures are not
obstruc ng the airway, leave them in place for what? -correct answers bag mask ven la on, as
it improves mask fi ng.
When preforming rapid sequence intuba on, the dose of benzos, barbiturates, and other
seda ves should be reduced to what percentage to minimize the risk of cardiovascular
depression? -correct answers 20-40%
Func onal changes in cardiac system include declining func on, decreased sensi vity to
catecholamines, atherosclerosis of coronary vessels, increased a erload, fixed heart rate (beta
blockers) -correct answers this results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Func onal changes in pulmonary system include decreased elas c recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex -correct answers thus they are at
increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
Func onal changes in renal system include loss of renal mass, decreased GFR, and decreased
sensi vity to ADH and aldosterone -correct answers resul ng in drug dosing for renal
insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
, Func onal changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
car lage, c spine degenera ve changes and loss of skin elas n and subcutaneous fat -correct
answers resul ng in increased risk for fractures, decreased mobility, difficulty for oral
intuba on, risk of skin injury, increased risk for hypothermia, challenges in rehabilia on
Func onal changes in Endocrine system include decreased produc on and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) -correct answers resul ng in occult
hypothyroidism, rela ve hypercor sone states and increased risk of infec on
True or false: Arthri s can complicate the airway and cervical spine. Pa ents can have mul level
degenera ve changes affec ng disk spaces and posterior elements associated with severe
central canal stenosis, cord compression, and myelomalacia -correct answers true
In elderly popula on, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ven la on is okay. In addi on, because
aging causes a suppressed heart rate response to hypoxia...... -correct answers respiratory
failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma pa ent at significant
risk for being inaccurately categorized as hemodynamically stable. -correct answers Elderly
pa ents have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older pa ents have
HTN, an acceptable BP may truly reflect a hypotensive state. A systolic BP of 110 is to be u lized
as the threshold for iden fying hypotension in pa ents 65 and older.
Do no equate blood pressure with shock in older pa ents -correct answers BP in older pa ents
may look normal due to the medica ons they are on. Use lactate and base deficit to evaluate
for evidence of shock
what 2 factors place elderly pa ents at risk for intracranial hemorrhage? -correct answers aging
causes dura to become more adherent to the skull increasing risk of injury and older pa ents
are on an coagulant and an platelet medica ons.
