“Older adults with major trauma are frequently under-triaged, increasing the risk of preventable morbidity and mortality. The aim of [a recent review published in the National Library of Medicine] was to evaluate the diagnostic performance of prehospital triage tools to identify suspected elderly trauma patients in need of specialized trauma care.
Several electronic databases were searched from inception to February 2019… Selection of studies, data extraction, and risk of bias assessments using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool were undertaken independently by at least two reviewers… Existing prehospital triage tools may not accurately identify elderly patients with serious injury. Future work should focus on more relevant reference standards, establishing the best trade-off between undertriage and overtriage, optimizing the role pre-hospital clinician judgment, and further developing geriatric specific triage variables and threshold.”
– “Diagnostic accuracy of prehospital triage tools for identifying major trauma in elderly injured patients: A systematic review” by Gordon Fuller, Abdullah Pandor, Munira Essat, Lisa Sabir, Helen Buckley-Woods, Hridesh Chatha, Chris Holt, Samuel Keating, and Janette Turner February 1, 2021
I think the key to the research outcomes is the “role of pre-hospital clinician judgment.” That means us! Yes, we can make a difference in the outcome of a resident who has sustained injury; we can determine the best course of care as that is what we are trained to do. We know our residents, we understand them, and we are best equipped to assist in the process of ensuring adequate, appropriate care is provided.
Stay well, mask up indoors, and stay tuned!