Trauma and the elderly: A case study

Abstract

Effective trauma management is a team effort. Communication and consultation between the team members is essential for smooth, efficient and sound trauma management. The challenges posed when caring for the elderly trauma patient will tax even the most proficient team. 60% of trauma deaths are patients aged over 55 years. The elderly undergo significant physiologic changes that disguise the normal stress response, such as arteriosclerotic arteries, reduced response to catecholamines, decreased cardiac output and myocardial contractility, muscular atrophy, decreased bone mass and decreased lung compliance. Other influencing factors are preexisting illnesses, current medications and the mechanism of injury. This case study illustrates the process of multi trauma in the elderly, the pathophysiology of pulmonary injury, pelvic fractures and hypovolemic shock as well as various management issues. Attention is drawn to the importance of communication between trauma team members and documentation as well as the significance of early consultation with the patient and family by senior medical staff regarding management and definitive care plans. The trauma nurse generally coordinates the patient care and the author highlights the importance of using all resources to obtain the highest level of care and efficient trauma management.