Geriatric Trauma Considerations Flashcards
6 cards from real ITLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Geriatric Trauma Considerations flashcards as text
An 88-year-old nursing home resident was found on the floor with a bruised and shortened, externally rotated right leg. What is the most likely injury?
Answer: Hip fracture (femoral neck or intertrochanteric)
A shortened, externally rotated leg after a fall in an elderly patient is the classic presentation of a hip fracture, the most common fracture requiring hospitalization in the elderly.
What is the concept of 'polypharmacy' and why is it particularly relevant to geriatric trauma assessment?
Answer: The use of multiple medications that can interact, mask injury signs, impair compensatory mechanisms, and contribute to fall risk
Polypharmacy refers to the use of multiple medications simultaneously. In geriatric trauma, these medications can mask vital sign changes, impair clotting, alter consciousness, and may have caused the injury through falls.
Why do elderly patients with traumatic brain injury have worse outcomes than younger patients with comparable injuries?
Answer: Brain atrophy increases subdural space, bridging veins are more vulnerable, reduced cognitive reserve limits recovery, and anticoagulant use worsens hemorrhage
Multiple age-related factors compound TBI severity: brain atrophy creates more space for bleeding before symptoms appear, stretched bridging veins tear easily, cognitive reserve is diminished, and common anticoagulant use worsens bleeding.
An elderly patient involved in a low-speed MVC denies any complaints and wants to refuse transport. Her vitals show BP 148/92 and HR 76. What ITLS principle applies to this situation?
Answer: Elderly patients may have significant occult injuries despite normal-appearing vital signs and minimal complaints due to decreased pain perception and medication effects
ITLS teaches that elderly trauma patients frequently have occult injuries masked by decreased pain perception, medications that alter vital signs, and the inability to mount appropriate physiologic responses. What appears stable may conceal life-threatening injuries.
What special consideration applies to spinal immobilization of elderly patients with significant kyphosis (forward curvature of the thoracic spine)?
Answer: Padding must be used to accommodate the kyphotic curve, as forcing the spine flat can cause pain, respiratory compromise, and potential neurologic injury
Elderly patients with kyphosis cannot be forced flat on a standard backboard. Adequate padding must fill the space beneath the thoracic curve and behind the head to maintain their normal spinal alignment and prevent iatrogenic injury.
Why is elder abuse an important consideration during ITLS assessment of geriatric trauma patients?
Answer: Unexplained injuries, inconsistent histories, patterned bruising, and signs of neglect may indicate abuse, and ITLS providers may be the first to recognize and report it
ITLS providers are often the first healthcare contact for abused elderly patients. Recognizing patterns of abuse (unexplained injuries, history inconsistent with findings, signs of neglect) is essential for patient protection and mandated reporting.