Elderly patients may sustain significant injuries with even minor trauma. A fall from a bed or from a standing position should be suspect for possible serious injury. Whether an accident was truly mechanical or was preceded by a syncopal or seizure event, caution should be practiced in evaluating the elderly. The timing of injury is an important historical feature to consider, as long periods of immobility following debilitating trauma may induce electrolyte abnormalities, muscle breakdown, rhabdomyolysis, and/or ensuing renal failure. The elderly may also be taking beta blocking and calcium-channel blocking agents. Due diligence needs to be taken in reviewing medications that may impact heart rate, blood pressure, and coagulation.63,64
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