Author: Rachel Brady, MD
- Elderly patients (>65 years old) have a higher trauma mortality compared to younger patients, even though they have lower mechanisms of injury
- Elder trauma is often under-triaged due to low-energy mechanisms and lack of physiologic response due to age and medications such as beta-blockers. Do not be reassured by normal vital signs.
- Image elderly patients with head injury aggressively since they are at high risk of intracranial bleeds
- Be sure to ask about anticoagulation use. Up to 15% of asymptomatic head injury patients on warfarin will have intracranial bleeds on CT.
- Be on the lookout for unstable C-spine injuries such as type II odontoid fractures
- Central cord syndrome is a possibility with any neck extension injury
- Rib fractures are common, with mortality increasing greatly with more than 2 ribs involved
- The elderly are more prone to musculoskeletal injuries due to loss of bone density
- Always discuss goals of care with these patients
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