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Perioperative management of the geriatric trauma patient 

Perioperative management of the geriatric trauma patient
Chapter:
Perioperative management of the geriatric trauma patient
Author(s):

Aris Sophocles

and Ashish C. Sinha

DOI:
10.1093/med/9780199604999.003.0017
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date: 20 August 2019

This chapter focuses on the physiological changes that affect the incidence of, and response to, perioperative management of traumatic injury in the elderly. Causes for increased morbidity and mortality in elderly patients than that found in younger patients suffering the same trauma are reviewed. Emphasis is placed on questioning why the trauma occurred; was it a dysrhythmia causing a fall or a stroke leading to a traffic collision? Elder abuse is discussed as a possible cause to be excluded. It reviews the specific physiological changes with age of particular relevance to the trauma patient including reduced responsiveness to hypoxia and hypercarbia, reduced airway sensitivity, and the frequency of silent aspiration in the elderly. Fluid balance is reviewed and the adverse effects of poor management highlighted. Brain and bony injuries are more common for any given traumatic event and the causes are reviewed. Finally, key anaesthetic considerations are reviewed.

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