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. - ANSTrue
In the elderly population, what is decreased physiological reserve? - ANSaging 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: - ANScirrhosis, coagulopathy, COPD,
ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - ANSFall. 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? - ANSadvanced 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? - ANSOlder 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 -
ANSTrue
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. - ANSthis 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? - ANSbag 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? - ANS20-40%
,Functional changes in cardiac system include declining function, decreased sensitivity to catecholamines,
atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta blockers) - ANSthis 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 - ANSthus 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 - ANSresulting 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 - ANSresulting 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) - ANSresulting 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 - ANStrue
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...... - ANSrespiratory 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. - ANSElderly 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 - ANSBP 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? - ANSaging 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. - ANSRapid 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. -
ANStrue
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.......? - ANSElder 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 - ANSTrue. A simple injury such as an open tibia fracture in a frail elderly
patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries - ANScommon injuries
in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True or False? -
ANSTrue. Also if xray examination is indicated during the pregnant patient's treatment, it should not be
withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. - ANSWhen the uterus enlarges
it pushes the bowel cephalad and the uterus lies in the upper abdomen. As a result, the bowel is
somewhat protected from blunt abdominal trauma, whereas the uterus and its contents (fetus and
data shows increased mortality with similar severity of injury in older adults. - ANSTrue
In the elderly population, what is decreased physiological reserve? - ANSaging 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: - ANScirrhosis, coagulopathy, COPD,
ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - ANSFall. 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? - ANSadvanced 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? - ANSOlder 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 -
ANSTrue
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. - ANSthis 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? - ANSbag 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? - ANS20-40%
,Functional changes in cardiac system include declining function, decreased sensitivity to catecholamines,
atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta blockers) - ANSthis 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 - ANSthus 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 - ANSresulting 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 - ANSresulting 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) - ANSresulting 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 - ANStrue
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...... - ANSrespiratory 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. - ANSElderly 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 - ANSBP 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? - ANSaging 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. - ANSRapid 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. -
ANStrue
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.......? - ANSElder 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 - ANSTrue. A simple injury such as an open tibia fracture in a frail elderly
patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries - ANScommon injuries
in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True or False? -
ANSTrue. Also if xray examination is indicated during the pregnant patient's treatment, it should not be
withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. - ANSWhen the uterus enlarges
it pushes the bowel cephalad and the uterus lies in the upper abdomen. As a result, the bowel is
somewhat protected from blunt abdominal trauma, whereas the uterus and its contents (fetus and
