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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