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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. - CORRECT ANSWER-True
In the elderly population, what is decreased physiological reserve? - CORRECT
ANSWER-aging is characterized by impaired adaptive and homeostatic
mechanisms that caused an increased susceptibility to the stress of injury.
Insults tolerated by the younger population can lead to devastating results in
elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - CORRECT
ANSWER-cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - CORRECT
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? - CORRECT ANSWER-
advanced age, physical impairment, history of previous fall, medication use,
dementia, unsteady gait, and visual, cognitive impairment
,Most of elderly traffic fatalities occur in the daytime and on weekends and
typically involve other vehicles. Why? - CORRECT 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, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older
adults remains high - CORRECT ANSWER-True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize
due to an adequate number of hair follicles, will result in a full thickness burn
in older patients. - CORRECT 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? -
CORRECT 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 depression? - CORRECT ANSWER-20-40%
Functional changes in cardiac system include declining function, decreased
sensitivity to catecholamines, atherosclerosis of coronary vessels, increased
afterload, fixed heart rate (beta blockers) - CORRECT 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 in pulmonary system include decreased elastic recoil,
reduced residual capacity, decreased gas exchange and decreased cough reflex
- CORRECT ANSWER-thus they are at increased risk for respiratory failure,
increased risk for pneumonia, and poor tolerance to rib fractures
,Functional changes in renal system include loss of renal mass, decreased GFR,
and decreased sensitivity to ADH and aldosterone - CORRECT ANSWER-
resulting in drug dosing for renal insufficiency, decreased ability to concentrate
urine, increased risk for AKI and urine flow may be normal with hypovolemia
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 - CORRECT 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 Endocrine system include decreased production and
response to thyroxin and decreased dehydroepiandrosterone (DHEA) -
CORRECT ANSWER-resulting in occult hypothyroidism, relative
hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients
can have multilevel degenerative changes affecting disk spaces and posterior
elements associated with severe central canal stenosis, cord compression, and
myelomalacia - CORRECT 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...... - CORRECT ANSWER-respiratory failure may present
insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma
patient at significant risk for being inaccurately categorized as
hemodynamically stable. - CORRECT 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.
Do no equate blood pressure with shock in older patients - CORRECT
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
what 2 factors place elderly patients at risk for intracranial hemorrhage? -
CORRECT ANSWER-aging causes dura to become more adherent to the skull
increasing risk of injury and older patients are on anticoagulant and antiplatelet
medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions
place elderly patients as risk for hypothermia and complications for immobility.
- CORRECT ANSWER-Rapid evaluation and when possible early liberation
from spine boards and cervical collars will minimize complications.
True or False: Fall prevention is the mainstay of reducing the mortality
associated with pelvic fractures. - CORRECT ANSWER-true
poor hygiene, dehydration, oral injury, contusions affecting the inner arms,
inner thighs, palms, soles, scalp, ear, nasal bridge and temple injury from being
struck while wearing glasses, contact burns and scalds. These are all signs
of.......? - CORRECT ANSWER-Elder maltreatment. The presence of physical
findings of maltreatment should prompt a detailed history. if history conflicts
with findings, immediately report findings to authorities.
True of false: early activation of the trauma team may be required for elderly
patients who do not meet traditional criteria for activation - CORRECT