Medical emergencies in trauma

Increasing elderly population means an increasing proportion of elderly trauma patients. This group commonly have associated chronic medical disorders which can influence the presentation and outcome of trauma. The common medical causes of trauma include falls, syncope, obstructive sleep apnoea and diabetes mellitus. Comorbid medical conditions mean poor physiological reserve and therefore the importance of timely medical intervention by early identification of a deteriorating patient. Modified Early Warning Score (MEWS) is one such tool which can help early idenfication of a deteriorating patient. Elderly trauma patients frequently develop medical complications while in the hospital and the trauma surgeon should be alert to this and initiate appropriate early management. The Acute Life-threatening Events Recognition and Treatment (ALERT^TM) course assessment algorithm (Figure 1) helps in this by providing a system for the comprehensive review of a critically ill patient. Trauma in elderly calls for a multidisciplinary approach and close cooperation between the elderly care physician and the trauma surgeon.