Prompt

Elderly faller on beta-blocker and DOAC, HR 70, SBP 110, chest wall pain. Discuss shock recognition and management.

Interpretation

Reveal interpretationShow

HR unreliable on beta-blocker; SBP 110 may be shock. Use lactate/base deficit. Liberal CT head.^[1] Reverse DOAC if ICH.^[3] Rib fractures high mortality — multimodal analgesia/HDU.^[4] Frailty (CFS) guides goals.^[2]

References4Show

[1]Jacobs DG, Plaisier BR, Barie PS, et al. Practice management guidelines for geriatric trauma: the EAST Practice Management Guidelines Work Group J Trauma, 2003.PMID 12579072
[2]Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people CMAJ, 2005.PMID 16129869
[3]Connolly SJ, Milling TJ Jr, Eikelboom JW, et al. Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors N Engl J Med, 2016.PMID 27573206
[4]Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly J Trauma, 2000.PMID 10866248

Prompt

Elderly faller on beta-blocker and DOAC, HR 70, SBP 110, chest wall pain. Discuss shock recognition and management.

Interpretation

Reveal interpretationShow

References4Show

[1]Jacobs DG, Plaisier BR, Barie PS, et al. Practice management guidelines for geriatric trauma: the EAST Practice Management Guidelines Work Group J Trauma, 2003.PMID 12579072
[2]Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people CMAJ, 2005.PMID 16129869
[3]Connolly SJ, Milling TJ Jr, Eikelboom JW, et al. Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors N Engl J Med, 2016.PMID 27573206
[4]Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly J Trauma, 2000.PMID 10866248

Geriatric trauma traps — beta-blockers and frailty

Interpretation

Geriatric trauma traps — beta-blockers and frailty

Interpretation