Aurelio Rodriguez Robert D. Barraco Rao R. Ivatury Editors Geriatric Trauma and Acute Care Surgery 123 Geriatric Trauma and Acute Care Surgery Aurelio Rodriguez Robert D. Barraco • Rao R. Ivatury Editors Geriatric Trauma and Acute Care Surgery Editors Aurelio Rodriguez Robert D. Barraco University of Maryland School of Lehigh Valley Health Network Medicine USF Morsani College of Medicine - Drexel University College of Medicine Lehigh Valley Baltimore, MD Allentown, PA USA USA Rao R. Ivatury Virginia Commonwealth University Richmond, VA USA ISBN 978-3-319-57402-8 ISBN 978-3-319-57403-5 (eBook) https://doi.org/10.1007/978-3-319-57403-5 Library of Congress Control Number: 2017962623 © Springer International Publishing AG, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by the registered company Springer International Publishing AG part of Springer Nature The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Contents Part I Introduction 1 Introduction .......................................... 3 C. W. Schwab 2 Why This Book and Why Now? A Rationale and Systems Impact for Geriatric Trauma and Acute Care Surgery ................................ 7 Robert D. Barraco, Aurelio Rodriguez, and Rao Ivatury Part II General Evaluation, Risk Assessment and Goals of Care (Trauma and Acute Care Surgery) 3 General Evaluation, Risk Management, and Goals of Care ..................................... 15 Alicia J. Mangram, Joseph F. Sucher, and James K. Dzandu Part III Trauma: Prehospital Care (Fluids, Immobilization and Transport, Triage, OOH DNR and POLST) 4 Prehospital Care ...................................... 29 Juan Duchesne and Connie DeLa’O Part IV Emergency Medicine 5 The Role of the Emergency Physician for Injured Geriatric Patient Care in the ED ......................... 41 Dave Milzman and Sarada Rao Part V Head Injury 6 Geriatric Concussions .................................. 55 Russell D. Dumire 7 Traumatic Extra-Axial Hemorrhage in the Elderly ......... 69 Jack Wilberger v vi Contents 8 T raumatic Subarachnoid Hemorrhage .................... 75 Jack Wilberger 9 N euro Critical Care ................................... 81 Mira Ghneim and Deborah M. Stein Part VI Spine Injury 10 G eriatric Cervical Spinal Trauma: History, Presentation, and Treatment ............................ 93 Victor Ryan Lewis, Stephen Curran Kane, Ira Martin Garonzik, and James Edmond Conway 11 Identification, Treatment, and Prognosis of Geriatric Thoracolumbar Spinal Trauma .......................... 101 Stephen C. Kane, Victor R. Lewis, James E. Conway, and Ira M. Garonzik Part VII Orthopedic Injury 12 G eriatric Hip Fractures ................................ 111 Ellen P. Fitzpatrick 13 Geriatric Acetabulum Fractures ......................... 123 Daniel T. Altman and Edward R. Westrick 14 Geriatric Long Bone Fractures .......................... 133 Jessica G. Kingsberg and Daniel T. Altman Part VIII Cardiothoracic Injury 15 Cardiac Trauma ...................................... 141 Benjamin Moran, Lars Ola Sjoholm, and Amy J. Goldberg 16 G eriatric Thoracic Vascular Injury ...................... 147 David Elliott and Aurelio Rodriguez 17 T horacic Trauma in the Elderly ......................... 157 T. Robert Qaqish, JoAnn Coleman, and Mark Katlic 18 E sophageal Injury ..................................... 167 Mathew A. Van Deusen, Mark Crye, and Jonathan Levy Part IX Abdominal Injury 19 Liver Trauma ......................................... 175 Adrian W. Ong and Rao R. Ivatury 20 O ptimal Management of Blunt Splenic Injury in the Geriatric Patient ................................. 181 James M. Haan Contents vii 21 Hollow Viscus Injury in Geriatric Trauma: Damage Control, Surgical Management, and Critical Care ...................................... 189 Arturo R. Maldonado and Juan L. Peschiera 22 Management of Pancreatic Injury in the Geriatric Patient ... 209 Charles E. Lucas and Anna M. Ledgerwood Part X Vascular Injury 23 Geriatric Cerebrovascular Injury ........................ 223 Peter B. Letarte 24 Geriatric Vascular Trauma and Vascular emergencies ....... 231 Justin Boccardo Part XI Urologic Injury 25 Geriatric Urologic Trauma ............................. 249 Gregory P. Murphy, Jack W. McAninch, and Benjamin N. Breyer Part XII Plastics/Skin and Soft Tissue Injury 26 Plastics/Skin and Soft-Tissue Injury Trauma .............. 257 Sharline Z. Aboutanos 27 Soft Tissue Infections in the Elderly ...................... 263 Margaret H. Lauerman and Sharon Henry Part XIII Thermal Injury 28 Thermal Injury ....................................... 273 Gabriel Hundeshagen, David N. Herndon, and Jong O. Lee Part XIV Acute Care Surgery Introduction: Common Abdominal Emergencies 29 System Impact and Demographics of Abdominal Surgical Emergencies .................................. 283 Laura S. Buchanan and Jose J. Diaz 30 Clostridium difficile Infection: Considerations in the Geriatric Population ........................................... 291 Molly Flanagan and Paula Ferrada 31 Acute Diverticulitis .................................... 299 Manuel Lorenzo and Vanessa Shifflette 32 Cholecystitis .......................................... 307 Syed Nabeel Zafar and Edward E Cornwell III viii Contents 33 G astrointestinal Bleeding in the Elderly Patient ............ 313 Russell J. Nauta 34 I ntestinal Obstruction in Geriatric Population ............. 319 Paula Ferrada, Ashanthi Ratnasekera, and Ricardo Ferrada 35 A cute Appendicitis .................................... 325 Tiffany N. Anderson, Frederick Moore, and Janeen Jordan Part XV Critical Care 36 Critical Care: Pulmonary ............................... 333 Nicole L. Werner and Lena M. Napolitano 37 Cardiac/Hemodynamic Monitoring ...................... 349 Jay Menaker and Thomas M. Scalea 38 Nutrition Assessment and Therapy ....................... 357 Kimberly Joseph 39 A cute Kidney Injury (AKI) ............................. 367 Ajai Malhotra 40 I nfections in the Geriatric Person Following Trauma ........ 381 Wayne Campbell and Alexander Chen Part XVI Post-Acute Care: Considerations in Disposition 41 Perioperative Management of the Geriatric Patient ......... 393 Bellal Joseph and Peter Rhee Part XVII Perioperative Management 42 P ost-acute Considerations in Disposition .................. 405 Laura Harmon, Leah Kohri, and Rosemary Kozar Part XVIII Nursing Considerations in the Geriatric Patient 43 N ursing Considerations in General Evaluation, Risk Management, and Goals of Care .................... 411 Cathy A. Maxwell 44 G eriatric Trauma: Emergency Nursing Considerations ...... 423 Jessica Jurkovich 45 N ursing Care of the TBI Patient ......................... 433 Jami Zipf 46 G eriatric Trauma: Spinal Injury Nursing Care ............. 437 Kai Bortz 47 C ardiothoracic Geriatric Trauma: Nursing Considerations .. 441 Matthew Mowry Contents ix 48 Nursing Care of the Client with Abdominal Trauma ........ 447 Elizabeth D. Katrancha 49 Nursing Considerations for Traumatic Geriatric Orthopedic Injuries ................................... 449 Elizabeth L. Price, Rajesh R. Gandhi, and Therese M. Duane 50 Geriatric Peripheral Vascular Injuries: Nursing Implications 455 Elizabeth Seislove 51 Geriatric Trauma Book: Urologic Trauma ................. 459 Kai Bortz 52 Geriatric Trauma Book: Skin ........................... 461 Kai Bortz 53 Nursing Considerations in the Care of Elderly Burn Patients 465 Jason Sheaffer 54 Perioperative Nursing Considerations .................... 475 Elizabeth D. Katrancha Index 477 Contributors Sharline Z. Aboutanos, M.D., F.A.A.P., F.A.C.S. Richmond Plastic Surgeons, Richmond, VA, USA Daniel T. Altman, M.D. Department of Orthopaedic Surgery, Drexel University College of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA Tiffany N. Anderson, M.D. University of Florida Academic Health Center, Gainesville, FL, USA Robert D. Barraco, M.D., M.P.H., F.A.C.S., F.C.C.P. Lehigh Valley Health Network, Allentown, PA, USA Justin Boccardo, M.D., F.A.C.S. Department of Vascular Surgery, Bayfront Punta Gorda, Punta Gorda, FL, USA Kai Bortz, M.S.N., R.N.-B.C., C.M.S.R.N., C.N.L., T.C.R.N Transitional Trauma Unit, Lehigh Valley Health Network, Allentown, PA, USA Benjamin N. Breyer, M.D. University of California - San Francisco Urology Department, San Francisco General Hospital, San Francisco, CA, USA Laura S. Buchanan, M.D. R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA Wayne Campbell, M.D. Department of Medicine-Infection Deseases, Union Memorial Hospital, Baltimore, MD, USA Alexander Chen Medstar Union Memorial Hospital, Baltimore, MD, USA JoAnn Coleman, D.N.P., A.C.N.P., A.O.C.N. Department of Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA Mark Crye, M.D. Department of Cardiovascular and Thoracic Surgery, Allegheny Health Network, Pittsburgh, PA, USA James Edmond Conway, M.D., Ph.D. Department of Neurosurgery at Sinai Hospital and Baltimore Neurosurgery and Spine Center, Baltimore, MD, USA Baltimore Neurosurgery and Spine Center, Baltimore, MD, USA xi