see also: [[Airway]] , [[Geriatric Trauma]], [[Peri-intubation collapse]] #tables # impacts of aging table | | impact of aging | clinical implication | | ----------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- | | Airway | - increase incidence of edentulous / arthritis TMJs and C-spine<br>- may have dentures<br>- floppy epiglottis<br> | - aim to BVM with dentures in<br>- anticipate difficult airway due to reduced mouth opening / neck mobility | | Breathing | - ↓ resp reserve 2/2 ↓ resp muscle strength, ↓ vital capacity. ↑ residual volume | - early supplemental O2 and resp support<br>- apoenic O2 for intubation<br>- early spirometry reduce atelectasis<br>- analgesia avoid splinting | | Circulation | - ↑ peripheral vascular resistance<br>- ↓ cardiac sensitivity to adrenergic stimulation<br>- ↓ baroreceptor sensitivity → less tachycardia due to hypovolaemia<br>- reliance of stroke volume for cardiac output<br>- reduced circulating volume<br>- reduced cardiac output | - medications need lower dose and take longer to get to effect site <br>- delays of recognising shock<br>- early fluid resus | | Disability | - cortical atrophy → ↑ bridging vein shearing causing SDH | ↑ ICH in setting of normal GCS | | Exposure | - premorbid malnutrition and immunosensence | - ↑ risk of hypothermia, pressure injuries, and infection |