Two subsets of the population are particularly sensitive to trauma: pediatric and geriatric patients. Pediatric patients are able to compensate for hemorrhage longer because they have robust physiologic reserves.[16] Geriatric patients are more sensitive to traumatic insults than their younger counterparts because they have limited physiologic reserves to respond to a traumatic injury and hemorrhagic shock, and they have a higher sensitivity to lower mechanisms of injury.[16] Geriatric fall injuries are five to 10 times more severe than falls in younger patients. [17] This is often because geriatric patients are usually on medications that can mask the signs and symptoms of hemorrhagic shock from occult bleeding.[17]
Advances in trauma care over the past decade reveal that the majority of the data exists from military trauma research. Historically, combat casualties resulted from potentially survivable injuries. Col. Ron Bellamy of the U.S. Army conducted research into the distribution of wound patterns in the Vietnam War and discovered three distinct injuries from which combat wounded could have potentially survived but did not. He found that of the soldiers that died in combat 60% did so from extremity trauma; 33% died from an undetected or untreated tension pneumothorax, and 7% died from airway compromise/obstruction.[17] Each of those were considered by Bellamy to be potentially survivable causes of death.
