Ep. 27 | Fragile & Fatal—Geriatric Low Impact Trauma
Low-impact doesn’t mean low-risk — especially when it comes to geriatric patients.
In this episode, we take a deep dive into the often-overlooked dangers of low-mechanism trauma in older adults. What may appear to be a simple fall or minor injury can quickly become life-threatening due to age-related physiological changes, comorbidities, delayed symptom presentation, and prolonged downtime.
We explore how aging affects nearly every body system — from fragile bones and thinning skin to slowed cardiovascular responses and altered pain perception — and why these changes make geriatric trauma fundamentally different from trauma in younger patients. Even ground-level falls or minor head strikes can result in serious injuries such as subdural hematomas, hip fractures, rib fractures, and internal bleeding that may not be immediately apparent.
This episode also focuses heavily on assessment challenges. Older adults often present atypically, with subtle or delayed symptoms, normal-appearing vital signs, or altered mental status that can mask serious injury. We discuss why maintaining a high index of suspicion is critical, even when the mechanism seems insignificant or the patient appears stable.
Beyond the physical exam, we talk about the importance of looking at the whole picture: environmental clues, medication use (including anticoagulants), baseline cognitive function, and social factors. We also discuss scenarios where a reported “fall” may actually be the result of an underlying medical condition — or, in some cases, neglect — and how these considerations should influence both assessment and transport decisions.
Finally, we walk through prehospital and hospital management strategies, emphasizing gentle handling, early pain control, cautious fluid management, and early transport to an appropriate facility. Early recognition and intervention can dramatically change outcomes for these patients — and missing subtle warning signs can be fatal.
