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Emergency Medical Minute


Aug 6, 2019

Author: Rachel Brady, MD

Educational Pearls:

  • 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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