UDK  616-001-053.9                       

ISSN 2466-2992 (Online) (2021) br.1, p. 23-27

COBISS.SR-ID 46923785



GERIATRIC TRAUMA


Tatjana Mićić,  Tatjana Rajković, Ivana Ilić


Emergency Medicine Service Niš, Serbia



Summary:


INTRODUCTION: Over the last few decades, advances in medicine have led to a significant increase in life expectancy, and thus to an increase in the elderly population. The consequence is an increasing number of elderly patients in general, including those with different types of injuries. While aging, certain physiological changes occur, as well as various pathological conditions. This puts the elderly at increased risk of injury, and when an injury occurs, the body's response can be altered.


DATA SOURCE: We reviewed more than 1,200 publications on geriatric trauma and guidelines for prehospital and hospital care of the injured published between Jan 2014 - April 2021. In selecting references, we were guided by the level of evidence.


SYNTHESIS OF THE EXAMINATION: Elderly patients most often have impaired vision and hearing, reduced bone density and joint flexibility, decreased muscle mass and muscle strength, impaired motor and cognitive functions, and generally reduced functional reserve. The result is more frequent injuries. Geriatric patients have a weakened heart reserve, lower cardiac output, a greater tendency to heart rhythm disorders and variations in blood pressure. Their compensation of hypoxia, hypercapnia and metabolic disorders is inadequate. Due to atherosclerotic changes, glomerulosclerosis also occurs, which results in loss of glomeruli and renovascular dysautonomy. Endocrine and immune factors may also influence the clinical picture and treatment outcome of elderly traumatized patients. When caring for elderly traumatized patients, the ABCDE approach should be used during the primary examination. "Normal" signs in an elderly patient may represent an occult state of shock. When replacing fluid, which should be  early, it is necessary to take into account any existing heart and kidney failure, ischemic heart disease, antiplatelet, anticoagulant and other therapies that the patient uses. Assessment of neurological function in the elderly may be difficult. The most common serious injuries in elderly patients are fractures of the clavicule, ribs, pelvic bones and extremities, injuries of the cervical spine and spinal cord, tarumatic brain injuries, as well as burns. Transport position should be adequate. In addition to fluid replacement, analgesia is also necessary. The patient should be monitored, ECG performed, blood analysis and other necessary diagnostics depending on the type of injury and the patient's condition as soon as possible.


CONCLUSION: Due to aging, geriatric patients are more prone to injury and more severe injuries. In the elderly, complications are more common, recovery is longer, and mortality is higher. Geriatric trauma care has its specifics that relate to the assessment of the injured patient's condition, hemostasis, fluid replacement, medication and other aspects. For that reason, it is necessary to know the physiological and pathophysiological changes in old age and to adjust the treatment to the patient.


Key words: trauma, elderly people, specificity.



Korespondencija/Correspondence

 

Tatjana MIĆIĆ

Emergency Medical Service Niš

Vojislava Ilića bb

18000 Niš

e-mail: tanjamcc@yahoo.com


Latest issue - 3rd article

009_Trauma kod starih_Micic_23-27.pdf

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