Trauma in Children and Elderly

7/27/2019 Trauma in Children and Elderly

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Developed by the

National Association of Emergency Medical Technicians

In cooperation with

The Committee on Trauma, American College of Surgeons

This slide presentation is intended for use onlyin approved PHTLS courses. 12-1B


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Our bodies and body systems growand develop throughout our lifetime.

In the young, the systems developand mature.

In the elderly, body systems begin toshow the effects of aging.

Life Span Development

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Assessment

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What is the mechanism?

What injuries do you expect?

ABCs.


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FindingsA - Snoring respirations.

B - Rapid, shallow respirations.

C - Weak, rapid pulse. No obvious bleeding.

D - Responds to painful stimulus.

E - No obvious external trauma.

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Note: It is 50 0 F and damp. Does thisaffect your assessment or treatment?


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Injury is the most frequent cause of death.

Approximately 20 - 40% may be

preventable.

Blunt mechanisms are more common,but instances of penetrating trauma haveincreased to nearly 15% of injuries.

Pediatric Trauma

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Mechanisms in Children

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Falls: 39%

Vehicular: 38%


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Smaller body absorbs energyin more concentrated area.

Softer skeleton.

Kinematics in Children

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Smaller airways.

Larger head and tongue.

Potential for immature respiratorymuscles, allowing for respiratory fatigue.

Airway & Breathing in Children

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Difficult to determine early signs of shock.

Compensate poorly.

Can deteriorate quickly.

Circulation in Children

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May be difficult to fully assess levelof consciousness.

Patients activity level and responseto environment may be the bestindicators.

Be patient and reassuring.

Disability in Children

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Larger surface area relative tooverall body weight and size.

Rapid loss of heat.

Hypothermia in Children

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Trauma in Children & the Elderly

Trauma in the Elderly

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Geriatric Trauma

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Growing part of the population.Falls are leading cause of trauma deaths;MVCs are second.


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Scenario

You are on scene with a 70-year-oldwoman who slipped and fell on an

icy stairway at a local church.

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What do you need to know?

What do you do?


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FindingsA - Open.

B - Rapid with slight wheeze.

C - 78 & regular. No obvious bleeding.

D - Lethargic & unable to move legsdue to pain.

E - No obvious external trauma.

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Respiratory function declines.

Chest wall less flexible.

Alveoli become smaller.

Less able to clear foreign matter from lungs;limits absorption of oxygen.

Lessened elasticity of lung causes decreasedability to exhale, resulting in CO 2 retention.

Airway & Breathing in the Elderly

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Decreased elasticity, thickening andnarrowing of blood vessels limit abilityto adapt to changes in blood flow.

This causes poor compensation inresponse to shock.

Condition can deteriorate quickly.

Circulation in the Elderly

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Effects of age may present problems inassessing level of consciousness.

Alzheimers disease.

Organic Brain Syndrome.

Sensory changes - vision, hearing, etc.

Disability in the Elderly

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The possibility of pre-existingdisease increases with age.

Medications are a major concern.Age and general physical condition

greatly influence response to injury.When immobilizing, additionalpadding will be required.

Pitfalls with the Elderly

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Managing Pediatrics & Geriatrics

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Treat these patients with the samepriority considerations: A, B, C, D, E...

When making assessments, consider thepatients age as a complicating factor.

Potential for rapid deteriorationmandates frequent re-assessment.


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Children & Elderly Summary

Identify the potential for age-specificcomplications, while keeping in mind

that treatment priorities do not change.Follow patient assessment withcontinual re-assessment.

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Trauma in Children and Elderly

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