Anatomy and physiology
Case examples could include – need to choice a medical condition then find a reason why they fell – e.g. orthostatic hypotension causing trauma
Common medical condition can include
• Atrial fibrillation
• Ischaemic heart disease
• Kidney disease
• Heart failure
• Parkinson
• Dementia
• Hypertension
• Type 2 diabetes
• Stroke
• osteoarthritis
Common trauma events
• neck of femur
• C spine fracture
• Intracerebral bleed – sub dural, extra dural
• Pelvic fracture
• Depressed skull fracture
Introduction
• Statistics on increasingly ageing population
• Burden on NHS / NHS expenditure
• Brief intro your choosen medical condition and trauma condition – what are they, how common, burden on NHS etc
Older people
• What are the major changes that occur in older people that make them more vulnerable to significant trauma.
Significance of ageing Falls – how common are they, what are the main causes of falls, why are they more prone to significant injury
2 paragraphs on your underlying medical condition – prevalence and complexity of this condition – go into a bit of details on the pathophysiology of the disease
2 paragraphs on the trauma condition – why are elderly more vulnerable to sig trauma from mild. Describe the pathophysiology of the trauma condition and recognition features. Maybe a small sentence on treatment.
Conclusion
Talk about the complexity of assessing elderly patients – complex medical conditons, multiple medications, delayed presentation of trauma condition, lack classic signs and symptoms. Finish off by saying elderly patients are increasing, challenging to assess and paramedics need to undertake an indepth patient assessment to consider the underlying medical conditions and potential trauma when attending these incidents.
Useful links
head injury: https://www.nice.org.uk/guidance/cg176
spinal trauma https://www.nice.org.uk/guidance/ng41
https://www.nice.org.uk/guidance/qs166/chapter/quality-statement-4-assessment-for-cervical-spine-injury
trauma in the elderly: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221775/
Management of elderly major trauma in London – https://www.c4ts.qmul.ac.uk/downloads/london-major-trauma-system-elderly-trauma-guidancesecond-editiondecember-2018.pdf
Statistics – use trauma aduit and research network – TARN data where all trauma in elderly is collected https://www.tarn.ac.uk/Content.aspx?c=3795
https://eprints.whiterose.ac.uk/127158/8/BJJ%20Manuscript%20resubmission%20R2%20referencedMMD%20Checked%20%281%29.pdf
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.979.4761&rep=rep1&type=pdf
