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lunes, 22 de agosto de 2016

Geriatric Trauma an Medical Illness

emDocs - August 21, 2016 - Authors: Levine M and Alkhawam L
Edited by: Simon E and Koyfman A
Resuscitation of the elderly trauma patient must be thoughtful but aggressive:
  • Heighten awareness that with age, signs and symptoms may be minimal, and that the outcome is often initially unclear, and commonly, but not necessarily poor.
  • Up to 85% of elderly trauma survivors return to baseline or independent function.
  • This justifies initial aggressive approach which can be reassessed later when patient/family wishes and prognosis becomes increasingly clear.
  • Less physiologic reserve leaves little time for delays in diagnosis and under- or over- resuscitation.
  • Blood is the fluid of choice.
  • The principles of diagnosis and management in trauma are the same regardless of age, but the incidence of physiologic changes and disease states mandates a different overall approach.
  • You may be the only one in the room who knows how sick the patient really is.