2024 ATLS Module 11 - Geriatric Trauma Latest Questions With Complete Grade A Answers
- what factors play a part in placing older adults at high risk from trauma?
Answer: -
-senescence of organ systems (both anatomically and physiologically) -preexisting disease states -frailty
*depression, substance abuse, maltreatment are additional risk factors to consider
- what is the condition of decreased physiologic reserve in the elderly?
Answer: - declining cellular function, eventually leading to organ failure, is part of the aging process.... it is characterized by impaired adaptive and homeostatic mechanisms that cause an increased susceptibility to the stress of injury
- what are the 5 preexisting conditions that impact the outcomes in trauma patients?
Answer:
-cirrhosis -coagulopathy -COPD -ischemic heart disease -diabetes mellitus
- what is the most common mechanism of fatal injury in the elderly population?
Answer: falls
*the risk of falling increases with age *nonfatal falls are more common in women & fractures are more common in women who fall
- what is the MCC of TBIs in elderly?
Answer: falls
- what are risk factors for falls?
Answer:
-advanced age -physical impairments -history of a previous falls -medication use 1 / 2
-dementia -unsteady gait -visual, cognitive, neurological impairments
*environmental factors: loose rugs, poor lighting, slippery/uneven surfaces
- what are the risk factors for MVC in elderly?
Answer:
-slower reaction times -larger blind spot -limited cervical mobility -decreased hearing -cognitive impairment
- when an elderly pt has dentures, what do you do with them when ventiliation?
Answer: if they are not obstructing the airway, leave in place during bag-mask
ventilation bc it improves mask fit
- how does elderly patients being edentulous affect airway ventilation?
Answer: -makes intubating easier but bag-mask ventilation more difficult
- what should be reduced when performing rapid sequence intubations in elderly?
Answer: doses of barbituates, benzodiazepines, and other sedatives to between 20- 40% to minimize risk of cardiovascular depression
- how does aging affect breathing?
Answer:
-changes in compliance of lungs/chest wall increase work of breathing -aging suppresses heart rate response to hypoxia... respiratory failure may present insidiously
- the elderly trauma pt with evidence of circulatory failure should be assumed to
be bleeding...what type of advanced monitoring should be considered to guide optimal resuscitation, given the potential for preexisting cardiovascular disease?
Answer:
central venous pressure echocardiography ultrasound
- why does the risk of epidural hematoma increase in elderly?
- / 2
Answer: aging causes the dura to become more adherent to skull