Vital signs in an elderly trauma patient can be misleading. Significant trauma can be present when vital signs are in a "normal" range for a younger person.
Patient selection: trauma patient >= 65 years of age
Clinical clues to more serious trauma:
(1) elevated age shock index [age*(shock index)]
(2) heart rate > 90 beats per minute
(3) systolic blood pressure < 110 mm Hg
Laboratory clues to more serious trauma:
(1) elevated serum lactate
(2) abnormal base deficit
However, both serum lactate and base deficit may be normal in elderly patients who die.
A high level of suspicion should be exercised for any older adult with trauma.
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