In treating elderly trauma patients a different approach should be adopted other than what is generally followed in the case of younger trauma patients, says Dr A.P.Kumaraguru, Consultant Orthopaedic Surgeon of KG Hospital.

He made this observation while making a presentation on “Poly trauma in elderly” for the post-graduate medical students at KG Hospital Auditorium recently.

Dr Kumaraguru said that the elderly population was getting bigger and bigger due to availability of good healthcare management, including the required medical facility and early diagnosis that put them on the rehabilitation path.

Causes of injury

The leading causes of injury in the elderly are: fall, burn, alcohol and motor vehicle crash. Even a small fall might lead to heavy bleeding. Poor vision would render them unsteady, thereby making them vulnerable to accidents. They might also suffer breathing and circulatory problems.

Dr Kumaraguru said that for the elderly trauma patient, CT scan must be taken immediately to ascertain whether the brain had suffered any damage; the airways must be checked for any possible obstruction and the secondary brain damage must be averted.

Even a denture in the airway might kill a patient much faster than subdural hematoma. They might also suffer unique neurological problems such as acute and chronic subdural hematomas, altered sensorium and spinal osteoarthritis.

Therefore, Dr Kumaraguru said that the following special issues should be taken into consideration while treating the elderly trauma patients: age related changes in anatomy and physiology, pre-existing diseases and co-morbidities, medications and possibility of elder abuse.

“If  abuse is suspected, the patient must be removed from the abusive environment and should not be probed in the presence of possible abuser,” Dr Kumaraguru added.

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