Don’t confuse the effects of aging with coexisting diseases. However, one can impact the other. Example: Bones of the elderly are less likely to withstand trauma. That may not mean the patient has osteoporosis.
We are living longer than ever before!
So, some stats refer to elderly as > 65 and some refer to this population as > 75
proprioception (prō'prē-ō-sěp'shən) The unconscious perception of movement and spatial orientation arising from stimuli within the body itself. In humans, these stimuli are detected by nerves within the body itself, as well as by the semicircular canals of the inner ear.
Older trauma victims may have significant comorbidities and may be taking medications that can complicate recovery and resuscitation.
For the most part, fall-related inpatient discharge rates increased as age increased, with the exception of those fours years of age or less. Other types of injuries peaked in the early to mid-adult age groups, Figures 4-6. Although peak rates for other injuries occurred at younger ages than for falls, there was considerable variability as to which age group was the most vulnerable to a specific type of injury. For the time period under study, 35-44 year olds were the most likely to be hospitalized for self-harm and 45-54 year olds for unintentional poisoning, while 15-24 year olds were the most likely to be victims of an assault or a motor vehicle crash.
Over 80% of patients who have fallen are on meds that are later discovered to be the cause of the fall. Antihypertensives can decrease the patient’s compensatory hemodynamic response to hemorrhage or blood loss. Anticoagulants and Antiplatelets can worsen the outcome for elderly trauma patients… especially head injuries. Then you have to balance the need for the therapy (patients w/ valve replacements, stroke, A-fib) against the need for immediate reversal (life-threatening hemorrhage, head bleed).
The pattern of injury for geriatric patients in motor vehicular trauma appears quite similar to the pattern of injury for younger patients, except for an increased incidence of sternal fractures from seatbelts.
The normal patho of aging and medical conditions can affect vision, reflexes, balance, and cognition. These changes can place elderly persons at high risk for involvement in motor vehicle crashes.
Elderly patients are frequently struck within marked crosswalks or walk directly into the path of an oncoming vehicle. Causes are listed:
Fatal injuries tend to be from severe head injury or major vascular damage. Most deaths occur at the scene or in the ED. Once hospitalized, patients die from complications of prolonged ventilation and infection. Recent data reveals that age plays a tremendous role in the severity of injury in pedestrians struck by motor vehicles. -Increase injuries to the brain, spine, & skeleton increase
Elderly patients make up 13% of all patients admitted to burn units. Total body surface area burned, Mortality, & Hospital length of stay are all higher in the elderly. As with other forms of trauma, burn treatment in the elderly is complicated by impaired functional reserve and coexisting diseases. No data suggests changes in the initial burn treatment protocols other than taking into consideration underlying medical conditions. However, transfer to a burn unit is recommended.
Bruises in multiple stages of healing, unexplained fractures, untreated injuries, signs of neglect such as dehydration, malnutrition, and bedsores are important clues to the possibility of abuse or neglect and should trigger further investigation. It is the responsibility of the clinician to report suspected abuse to the proper authorities.
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