Elderly Trauma

For the first time there are 11.5 million people aged 65 or over living in the UK, which equates to 18% of the population (Figure: Office For National Statistics 2015).

Nationally this is the fastest growing age group in the UK and the Office for National Statistics estimate that by 2040 one in four people in the UK will be aged 65 or over.

The Trauma Audit Research Network (TARN) reported that major trauma patients in England and Wales are becoming more elderly, and low level falls are now a leading cause of severe injury. However there are currently few clinical guidelines which specifically focus on the needs of injured elderly patients admitted to major trauma networks.

The pan London elderly trauma group comprises multi-disciplinary professionals with expertise and interest in managing older injured patients. This group have produced clinical guidance for the management of elderly trauma patients within Major Trauma Centres and Trauma Units. Clinical commissioning standards for the care of this group of patients have been proposed within the guidelines, for discussion with the National Clinical Reference group and other key stakeholders.

Download the guidelines for management of elderly trauma patients

Definition of 'elderly'

Published reports on the care of the older trauma patient lack consensus for the definition of which age may be considered ‘elderly’. For the purposes of our work, elderly is defined as a patient aged 70 years or over. We acknowledge that this may be 60 or 65 in some trauma settings.

Elderly trauma screening tool

For older trauma patients who don’t triage a trauma team activation, we recommend that EDs use an elderly specific screening tool (such as the image below) in order to reduce the risk of missed injuries, ensure appropriate management pathways and promote optimal outcomes.

TUs, MTCs and LEHs within the LMTS may use this tool. Alternatively, units should ensure that local guidance contains elderly specific triage criteria.

RCEM have recently published this guidance which may also be useful to raise elderly trauma awareness in ED staff.

Group Membership

Adam Woodgate, Consultant EM, Royal London Hospital (Group lead)

Elaine Cole, Director of Research and Innovation, Pan London Major Trauma System (Co-lead)

Raju Ahluwalia, Consultant Orthopaedic Surgeon Kings College Hospital

Dan Bailey, Consultant Geriatrician, Kings College Hospital

Kat Baird, EM Specialist Registrar, NELETN

Duncan Bew, Consultant Trauma Surgeon, Kings College Hospital

Trish Burton, Trauma Nurse Coordinator, Royal London Hospital

Nicola Dover, ED Senior Practice Development Nurse, North Middlesex University Hospital

Michael Fertleman, Consultant Geriatrician, St Marys Hospital

Laura Gallagher, Network Manager, NELETN

Derek Hicks, Consultant EM/Network Director NELETN

Heather Jarman, Consultant Nurse ED, St George's Hospital

George Peck, Consultant Geriatrician (Major Trauma), St Mary's Hospital

Donna Peel, EM Specialist Registrar, SWLSTN

Dhanupriya Sivapathasuntharam, Consultant Geriatrician, Royal London Hospital

Rhonda Sturley, Consultant Geriatrician, St Georges Hospital

Jane Tippett, Consultant Nurse ED, Kings College Hospital

Harriet Tucker, EM Specialist Registrar, SWLSTN

Julie Vowles, Consultant Geriatrician, Hillingdon Hospital

Karen Wheeler, Trauma Nurse Coordinator, North Middlesex University Hospital


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