Prehospital Care of the Elderly Trauma Patient (3 hours - Basic, Intermediate, and Paramedic levels)

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1. Aging and elderly population in the U.S. (15 minutes)
   1. Current
   2. Projected
   3. Percentage of use of the health care system

2. Systemic Decline secondary to aging (45 minutes)
   1. Cardiovascular
   2. Respiratory
   3. Renal
   4. Nervous
   5. Musculoskeletal
   6. Gastrointestinal

3. Chief complaint vs. Primary problem in the elderly patient (15 minutes)
   1. Chief complaint/definition
   2. Primary problem/definition
   3. Need to distinguish; difficulties

4. Factors complicating clinical evaluation of the elderly patient (10 minutes)
   1. Difficulty distinguishing between effects of aging/consequences of disease.
   2. Poor historians
   3. Multiple problems
   4. Diminished sense of pain
   5. Alteration in temperature regulating mechanism
   6. Social/emotional factors

5. Factors making elderly patients more susceptible to trauma (20 minutes)
   1. Difficulty in sight or hearing
   2. Altered sensorium
   3. Loss of calcium and bone integrity
   4. Diminished reflexes
   5. Loss of elasticity in peripheral vasculature

6. Environmental changes and their impact (15 minutes)
   1. More susceptible to hypo/hyperthermia problems due to unstable temp regulation
   2. Need more light to be stimulated
   3. Drugs may affect thermoregulation of patient
   4. Poor nutrition/inadequate liquid intake

7. Abuse and neglect of the elderly (45 minutes)
   1. Mandated reports/state and local laws
   2. Types of abuse
   3. Types of neglect
   4. Community/state resources

8. Medication precautions (15 minutes)
   1. Review patient's meds prior to administration of anything
   2. Interactions of commonly prescribed drugs for the elderly
   3. Importance of determining whether patient has take prescribed drug, and when.