QUESTIONS & VERIFIED ANSWERS|A+ GRADED|BRAND NEW
True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults.
ANSWER
True
Pre-existing conditions that affect morbidity and mortality include:
ANSWER
cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
In the elderly population, what is decreased physiological reserve?
ANSWER
aging is characterized by impaired adaptive and homeostatic mechanisms that caused an in-
creased susceptibility to the stress of injury. Insults tolerated by the younger population can
lead to devastating results in elderly patients.
What is the most common mechanism of injury in the elderly?
ANSWER
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 population, what are risk factors for falls?
ANSWER
advanced age, physical impairment, history of previous fall, medication use, dementia, un-
steady gait, and visual, cognitive impairment
1
,Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why?
ANSWER
Older people drive on more familiar roads and at lower speeds and tend to drive during the
day. Older people have slower reaction time, a larger blind spot, limited cervical mobility, de-
creased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults re-
mains high
ANSWER
True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an ade-
quate number of hair follicles, will result in a full thickness burn in older patients.
ANSWER
this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are
not obstructing the airway, leave them in place for what?
ANSWER
bag mask ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other
sedatives should be reduced to what percentage to minimize the risk of cardiovascular de-
pression?
ANSWER
20-40%
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex
2
,ANSWER
thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor
tolerance to rib fractures
Functional changes in cardiac system include declining function, decreased sensitivity to cat-
echolamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers)
ANSWER
this results in lack of classic response to hypovolemia, risk for cardiac ischemia, elevated BP
at baseline, and increased risk of dysrythmias.
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints
and cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat
ANSWER
resulting in increased risk for fractures, decreased mobility, difficulty for oral intubation, risk
of skin injury, increased risk for hypothermia, challenges in rehabiliation
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone
ANSWER
resulting in drug dosing for renal insufficiency, decreased ability to concentrate urine, in-
creased risk for AKI and urine flow may be normal with hypovolemia
Functional changes in Endocrine system include decreased production and response to thy-
roxin and decreased dehydroepiandrosterone (DHEA)
ANSWER
resulting in occult hypothyroidism, relative hypercortisone states and increased risk of infec-
tion
3
, True or false: Arthritis can complicate the airway and cervical spine. Patients can have multi-
level degenerative changes affecting disk spaces and posterior elements associated with se-
vere central canal stenosis, cord compression, and myelomalacia
ANSWER
true
In elderly population, due to their changes in pulmonary system, placing a gauze between
gums and cheek to achieve seal when using bag valve mask ventilation is okay. In addition,
because aging causes a suppressed heart rate response to hypoxia......
ANSWER
respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at signifi-
cant risk for being inaccurately categorized as hemodynamically stable.
ANSWER
Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to
hypovolemia will involve increasing their systemic vascular resistance. Furthermore, since
older patients have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic
BP of 110 is to be utilized as the threshold for identifying hypotension in patients 65 and
older.
what 2 factors place elderly patients at risk for intracranial hemorrhage?
ANSWER
aging causes dura to become more adherent to the skull increasing risk of injury and older
patients are on anticoagulant and antiplatelet medications.
Do no equate blood pressure with shock in older patients
ANSWER
BP in older patients may look normal due to the medications they are on. Use lactate and
base deficit to evaluate for evidence of shock
4
True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults.
ANSWER
True
Pre-existing conditions that affect morbidity and mortality include:
ANSWER
cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
In the elderly population, what is decreased physiological reserve?
ANSWER
aging is characterized by impaired adaptive and homeostatic mechanisms that caused an in-
creased susceptibility to the stress of injury. Insults tolerated by the younger population can
lead to devastating results in elderly patients.
What is the most common mechanism of injury in the elderly?
ANSWER
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 population, what are risk factors for falls?
ANSWER
advanced age, physical impairment, history of previous fall, medication use, dementia, un-
steady gait, and visual, cognitive impairment
1
,Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why?
ANSWER
Older people drive on more familiar roads and at lower speeds and tend to drive during the
day. Older people have slower reaction time, a larger blind spot, limited cervical mobility, de-
creased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults re-
mains high
ANSWER
True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an ade-
quate number of hair follicles, will result in a full thickness burn in older patients.
ANSWER
this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are
not obstructing the airway, leave them in place for what?
ANSWER
bag mask ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other
sedatives should be reduced to what percentage to minimize the risk of cardiovascular de-
pression?
ANSWER
20-40%
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex
2
,ANSWER
thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor
tolerance to rib fractures
Functional changes in cardiac system include declining function, decreased sensitivity to cat-
echolamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers)
ANSWER
this results in lack of classic response to hypovolemia, risk for cardiac ischemia, elevated BP
at baseline, and increased risk of dysrythmias.
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints
and cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat
ANSWER
resulting in increased risk for fractures, decreased mobility, difficulty for oral intubation, risk
of skin injury, increased risk for hypothermia, challenges in rehabiliation
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone
ANSWER
resulting in drug dosing for renal insufficiency, decreased ability to concentrate urine, in-
creased risk for AKI and urine flow may be normal with hypovolemia
Functional changes in Endocrine system include decreased production and response to thy-
roxin and decreased dehydroepiandrosterone (DHEA)
ANSWER
resulting in occult hypothyroidism, relative hypercortisone states and increased risk of infec-
tion
3
, True or false: Arthritis can complicate the airway and cervical spine. Patients can have multi-
level degenerative changes affecting disk spaces and posterior elements associated with se-
vere central canal stenosis, cord compression, and myelomalacia
ANSWER
true
In elderly population, due to their changes in pulmonary system, placing a gauze between
gums and cheek to achieve seal when using bag valve mask ventilation is okay. In addition,
because aging causes a suppressed heart rate response to hypoxia......
ANSWER
respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at signifi-
cant risk for being inaccurately categorized as hemodynamically stable.
ANSWER
Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to
hypovolemia will involve increasing their systemic vascular resistance. Furthermore, since
older patients have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic
BP of 110 is to be utilized as the threshold for identifying hypotension in patients 65 and
older.
what 2 factors place elderly patients at risk for intracranial hemorrhage?
ANSWER
aging causes dura to become more adherent to the skull increasing risk of injury and older
patients are on anticoagulant and antiplatelet medications.
Do no equate blood pressure with shock in older patients
ANSWER
BP in older patients may look normal due to the medications they are on. Use lactate and
base deficit to evaluate for evidence of shock
4
