Trauma & Triage Geriatric Teaching Moments from A.J. Heightman, MPA, EMT-P – JEMS Editor-in-Chief relative to the Texas Church Mini Bus Crash that Killed 13 Senior Citizens

When 13 senior citizens were killed in a horrible head-on collision between a San Antonio church mini bus and a pickup truck in southwest Texas, the AP story noted that the elderly occupants “were more susceptible to internal injuries and damage to vulnerable organs because of their advanced ages.” (see below as presented by the Associated Press). As an educator who spends a lot of time educating crews about the unique impact trauma can have on geriatric patients, I thought I would take the opportunity to present a few important facts about geriatric trauma and assessment tips to remember when you are tasked with triaging, assessing and treating geriatric trauma patients.   The first thing to remember is that, after age 30, there’s a 1% organ function loss per year. Cardiovascular effects: 1.       What appears to be a NORMAL heart rate in the geriatric patient may not be normal at all. In TRAUMA Cases, tachycardia – a classic symptom of shock – may NOT be present as your patient bleeds out!   The reason: Over time, catecholamines such as epinephrine and norepinephrine affect the heart LESS, reducing the body’s ability to increase heat rate and stroke volume in response to stress and shock, so if a geriatric patient cannot increase their heart rate and cardiac output to adjust to blood loss (shock) their BP will drop. 2.       Syncope in the elderly is a GRAVE sign until proven otherwise. S...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Major Incidents News Category Orientation Patient Care Source Type: news