The Geriatric Patient

RC308D

The Geriatric Patient

Refresher/Informatics

Presented on December 2, 2014
Presented as part of RC308: Emergency Imaging in Vulnerable Populations—Considerations and Calibrations

Claudia Theresa Sadro MD, Presenter: Nothing to Disclose

1) Epidemiology of geriatric trauma. 2) Imaging protocols for the geriatric patient who sustains minor and major trauma including the value of CT, when to order MRI and thresholds for angiography. 3) Guidelines for measuring renal dysfunction and giving intravenous iodinated contrast in the setting of renal dysfunction in geriatric patients. 4) Unique patterns of injury encountered in geriatric patients will be shown with clinical examples including head trauma, spine trauma, rib fractures and chest trauma, abdominal trauma, pelvic fractures and extremity fractures. Special attention will be made to traumatic injury in patients on anticoagulants, steroids and bisphosphonates. 5) Pre-existing medical conditions and incidentalomas in geriatric patients. 6) Prevention of geriatric trauma.

The geriatric population is the most rapidly growing sector of the US population, and emergency departments are seeing an increasing number of geriatric trauma patients. Geriatric patients are at risk for serious injuries following relatively minor trauma. Underestimation of their injuries based on mechanism of action by caregivers and health care personnel is a significant cause of morbidity and mortality in this age group. Radiology plays an important role in the early work up of these patients. CT in the mainstay of imaging. There is less concern about the risk of cancer from ionizing radiation in this age group. Intravenous contrast may be administered in patients with normal renal function. In patients with impaired renal function, it is important to follow guidelines appropriate for age. Geriatric patients have different injury patterns than younger patients and are at increased risk of serious complications from minor injuries. They require early diagnosis and aggressive intervention to decrease mortality and to enable them to return to independent living. This review will discuss head injury, spine injury, rib fractures, blunt abdominal trauma, pelvic fractures, extremity fractures and pre-existing illness as it pertains to radiology in the geriatric population