Geriatric trauma: what to think about before assessing, treating and packaging the elderly

Area of Science:

• Geriatric Emergency Medicine
• Trauma Care
• Pre-hospital Care

Background:

• Falls are a significant cause of injury and mortality in the elderly population.
• Senior residences are common settings for fall-related incidents requiring emergency medical services (EMS).
• Initial scene assessment in geriatric falls can be challenging due to potential for widespread pain and injury.

Purpose of the Study:

• To describe a clinical scenario involving an elderly female fall victim in a senior residence.
• To emphasize the critical need for comprehensive patient assessment in geriatric fall cases.
• To highlight potential challenges in pre-hospital care for elderly patients experiencing falls.

Main Methods:

• A case vignette is presented from the perspective of responding EMS personnel.
• The scenario details the initial scene, patient presentation, and communication with on-scene fire department EMTs.
• Focus is placed on the patient's condition and the initial challenges in assessment.

Main Results:

• An approximately 80-year-old female was found supine on the floor after a fall from a standing position.
• The patient was conscious and following commands but exhibited pain upon palpation.
• Initial EMS providers reported difficulty in performing a complete assessment due to patient discomfort.

Conclusions:

• Elderly fall patients require meticulous assessment to identify all injuries, even when pain is generalized.
• Effective pain management is crucial for facilitating a thorough patient assessment in geriatric falls.
• Standardized protocols for geriatric fall assessment should be consistently applied in pre-hospital settings.