ATLS MODULE 11 GERIATRIC TRAUMA
• why does the risk of epidural hematoma increase in elderly?
Answer: aging causesthe dura to become more adherent to skull
*also, they are more commonly prescribed anticoagulations and antiplatelets
• why are elderly patients at increased risk for rib fractures?
Answer: anatomicalchanges of chest wall & loss of bone density
*MCC is ground level fall, followed by MVC
• what is the primary complication of rib fractures in the elderly?
Answer: pneumonia
• what is the main objective of treatment for rib fractures in elderly?
Answer: paincontrol and pulmonary hygiene
• in elderly patients with TBIs, some patients may be on anticoagulant therapy...
therefore, aggressive and early reversal may improve outcome... what may this be
accomplished by?
Answer:
-prothrombin complex concentrate
-plasma
-vitamin K
• what are the 6 categories of elder maltreatment?
Answer:
1. physical
2. sexual
3. neglect
4. psychological
5. financial and material exploitation
6. violation of rights
• a geriatric trauma pt may be in shock despite vital signs that appear normaldue to:
Answer: cardiovascular dz
*preexisting cardio dz hx may include HTN, so BP in normal range is actually low for
these patients... also, pts may be taking beta blockers which can block tachycardia
expected with shock
, • why are burn injuries so devastating to older adults?
Answer: aging organ systems,including skin changes... and the inability to meet
physiological demands of burn injury due to decreased mobility
• what are the functional changes to the cardiac system in elderly?
Answer:
-declining function
-decreased sensitivity to catecholamines
-decreased myocyte mass
-atherosclerosis of coronary vessels
-increased afterload
-fixed cardiac output
-fixed HR (beta blockers)
• what are the functional changes to the pulmonary system in elderly?
Answer:
-thoracic kyphocoliosis
-decreased transverse thoracic diameter
-decreased elastic coil
-reduced functional residual capacity
-decreased gas exchange
-decreased cough reflex
-decreased mucociliary function
-increase oropharyngeal colonization
• what are the functional changes to the renal system in elderly?
Answer:
-loss ofrenal mass
-decreased GFR
-decreased sensitivity to antidiuretic hormone & aldosterone
• what are the functional changes to the skin/soft tissue/msk system inelderly?
Answer:
-loss of lean body mass
-osteoporosis
-changes in joints/cartilages
-degenerative changes
-loss of skin elastin and subcutaneous fat
• what are the functional changes to the endocrine system in elderly?
Answer:
• why does the risk of epidural hematoma increase in elderly?
Answer: aging causesthe dura to become more adherent to skull
*also, they are more commonly prescribed anticoagulations and antiplatelets
• why are elderly patients at increased risk for rib fractures?
Answer: anatomicalchanges of chest wall & loss of bone density
*MCC is ground level fall, followed by MVC
• what is the primary complication of rib fractures in the elderly?
Answer: pneumonia
• what is the main objective of treatment for rib fractures in elderly?
Answer: paincontrol and pulmonary hygiene
• in elderly patients with TBIs, some patients may be on anticoagulant therapy...
therefore, aggressive and early reversal may improve outcome... what may this be
accomplished by?
Answer:
-prothrombin complex concentrate
-plasma
-vitamin K
• what are the 6 categories of elder maltreatment?
Answer:
1. physical
2. sexual
3. neglect
4. psychological
5. financial and material exploitation
6. violation of rights
• a geriatric trauma pt may be in shock despite vital signs that appear normaldue to:
Answer: cardiovascular dz
*preexisting cardio dz hx may include HTN, so BP in normal range is actually low for
these patients... also, pts may be taking beta blockers which can block tachycardia
expected with shock
, • why are burn injuries so devastating to older adults?
Answer: aging organ systems,including skin changes... and the inability to meet
physiological demands of burn injury due to decreased mobility
• what are the functional changes to the cardiac system in elderly?
Answer:
-declining function
-decreased sensitivity to catecholamines
-decreased myocyte mass
-atherosclerosis of coronary vessels
-increased afterload
-fixed cardiac output
-fixed HR (beta blockers)
• what are the functional changes to the pulmonary system in elderly?
Answer:
-thoracic kyphocoliosis
-decreased transverse thoracic diameter
-decreased elastic coil
-reduced functional residual capacity
-decreased gas exchange
-decreased cough reflex
-decreased mucociliary function
-increase oropharyngeal colonization
• what are the functional changes to the renal system in elderly?
Answer:
-loss ofrenal mass
-decreased GFR
-decreased sensitivity to antidiuretic hormone & aldosterone
• what are the functional changes to the skin/soft tissue/msk system inelderly?
Answer:
-loss of lean body mass
-osteoporosis
-changes in joints/cartilages
-degenerative changes
-loss of skin elastin and subcutaneous fat
• what are the functional changes to the endocrine system in elderly?
Answer:
