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ATLS EXAM QUESTIONS WITH COMPLETE SOLUTIONS VERIFIED GRADED A+ True or false? Although the mechanism of injury may be similar to those for the younger population, data shows increased mortality with similar severity of injury in older adults. True In the elderly population, what is decreased p...

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  • 11 mei 2024
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ATLS EXAM QUESTIONS WITH COMPLETE SOLUTIONS

VERIFIED GRADED A+


True or false? Although the mechanism of injury may be similar to those for the

younger population, data shows increased mortality with similar severity of injury

in older adults.

True

In the elderly population, what is decreased physiological reserve?

aging is characterized by impaired adaptive and homeostatic mechanisms that caused

an increased susceptibility to the stress of injury. Insults tolerated by the younger

population can lead to devastating results in elderly patients.

Pre-existing conditions that affect morbidity and mortality include:

cirrhosis, coagulopathy, COPD, ischemic heart disease, DM

What is the most common mechanism of injury in the elderly?

Fall. Nonfatal falls are common in women and fractures are common in women who fall.

Falls are the most common cause of TBI.

In the elderly population, what are risk factors for falls?

advanced age, physical impairment, history of previous fall, medication use, dementia,

unsteady gait, and visual, cognitive impairment

Most of elderly traffic fatalities occur in the daytime and on weekends and

typically involve other vehicles. Why?

,Older people drive on more familiar roads and at lower speeds and tend to drive during

the day. Older people have slower reaction time, a larger blind spot, limited cervical

mobility, decreased hearing, and cognitive impairment.

True or False? Mortality associated with small to moderate sized burns in older

adults remains high

True

Spilled hot liquids on the leg, which in younger patients may re-epithelialize due

to an adequate number of hair follicles, will result in a full thickness burn in older

patients.

this is true

Airway-patients may have dentures that may loosen or obstruct the airway. If

dentures are not obstructing the airway, leave them in place for what?

bag mask ventilation, as it improves mask fitting.

When preforming rapid sequence intubation, the dose of benzos, barbiturates,

and other sedatives should be reduced to what percentage to minimize the risk of

cardiovascular depression?

20-40%

Functional changes in cardiac system include declining function, decreased

sensitivity to catecholamines, atherosclerosis of coronary vessels, increased

afterload, fixed heart rate (beta blockers)

this results in lack of classic response to hypovolemia, risk for cardiac ischemia,

elevated BP at baseline, and increased risk of dysrythmias.

,Functional changes in pulmonary system include decreased elastic recoil,

reduced residual capacity, decreased gas exchange and decreased cough reflex

thus they are at increased risk for respiratory failure, increased risk for pneumonia, and

poor tolerance to rib fractures

Functional changes in renal system include loss of renal mass, decreased GFR,

and decreased sensitivity to ADH and aldosterone

resulting in drug dosing for renal insufficiency, decreased ability to concentrate urine,

increased risk for AKI and urine flow may be normal with hypovolemia

Functional changes to MSK include loss of lean body mass, osteoporosis,

changes in joints and cartilage, c spine degenerative changes and loss of skin

elastin and subcutaneous fat

resulting in increased risk for fractures, decreased mobility, difficulty for oral intubation,

risk of skin injury, increased risk for hypothermia, challenges in rehabiliation

Functional changes in Endocrine system include decreased production and

response to thyroxin and decreased dehydroepiandrosterone (DHEA)

resulting in occult hypothyroidism, relative hypercortisone states and increased risk of

infection

True or false: Arthritis can complicate the airway and cervical spine. Patients can

have multilevel degenerative changes affecting disk spaces and posterior

elements associated with severe central canal stenosis, cord compression, and

myelomalacia

true

, In elderly population, due to their changes in pulmonary system, placing a gauze

between gums and cheek to achieve seal when using bag valve mask ventilation

is okay. In addition, because aging causes a suppressed heart rate response to

hypoxia......

respiratory failure may present insidiously in older adults.

Age related changes in the cardiovascular system place the elderly trauma

patient at significant risk for being inaccurately categorized as hemodynamically

stable.

Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to

hypovolemia will involve increasing their systemic vascular resistance. Furthermore,

since older patients have HTN, an acceptable BP may truly reflect a hypotensive state.

A systolic BP of 110 is to be utilized as the threshold for identifying hypotension in

patients 65 and older.

Do no equate blood pressure with shock in older patients

BP in older patients may look normal due to the medications they are on. Use lactate

and base deficit to evaluate for evidence of shock

what 2 factors place elderly patients at risk for intracranial hemorrhage?

aging causes dura to become more adherent to the skull increasing risk of injury and

older patients are on anticoagulant and antiplatelet medications.

Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions

place elderly patients as risk for hypothermia and complications for immobility.

Rapid evaluation and when possible early liberation from spine boards and cervical

collars will minimize complications.

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