- Vital signs and physical exam are often unreliable
- Use Pulse of 90 and SBP or 110 as criteria for TCI
- Use Shock Index X age to identify occult shock (should be <50)
- Lactate is most sensitive laboratory measurement of geriatric shock
- Lactate > 2 is concerning
- Low threshold for CT scanning in elderly
- Minor trauma + anticoagulants or antiplatelet other than ASA = Head CT
- Use Geriatric Trauma Score to determine need for ICU
- Each rib fracture beyond 3 increases mortality by 18%
- Geriatric patients die not with a bang but with a whimper