Lightning Learning: Stealth Trauma
““Stealth Trauma is when a low impact mechanism can cause severe injuries in frail older people.””
What?
Low impact mechanisms can cause severe injuries in frail older people.
A fall from standing height can cause:
Traumatic Brain Injury
C-Spine #’s
Rib #’s
Hip #’s
Undertriage happens due to differing baseline parameters:
A hypertensive patient with a SBP of 110 may be shocked
HR may be unreliable due to Beta Blockers
Stealth trauma is sly – if you don’t consider it you may miss severe injuries.
CT is the imaging modality of choice.
Why?
1 in 3 people aged >65yrs and
1 in 2 aged >85yrs fall each year.
Half will fall recurrently.
67.4% of all trauma unit admissions last year were due to injuries sustained following a fall from <2m.
Rib fractures alone are associated with twice the mortality in older adults compared to younger patients.
Early CT scanning helps identify occult injury and limits prolonged immobilisation which is associated with a risk of significant complications in the older patient.
How?
Read the NICE Head Injury Guideline (CG 176 )
Participate in SIM
Visit: http://bit.ly/geritrauma
TARN: https://www.tarn.ac.uk/
LITFL: http://lifeinthefastlane.com/what-the-elderly-should-say
The latest Lightning Learning and the next two sims are themed around Geriatric Emergency Medicine (GEM). If you are interested in learning more about GEM including stealth trauma why not join us at #GEMcon16 - a one Day GEM conference. Details can be found here. Don't forget to also follow @GEMcon16 on twitter.
