University of Hertfordshire

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Original languageEnglish
JournalEmergency Medicine Journal
Journal publication date2018
Publication statusSubmitted - 2018

Abstract

Background Older people represent a rapidly expanding proportion of the population. Nationally, older trauma patients form 20% of all major trauma presentations. Altered clinical manifestation and physiological reserve complicate clinical assessment and decision-making. To date, no Helicopter Emergency Medical Service has reported older trauma in the United Kingdom (UK). Methods A single centre, retrospective descriptive analysis of older trauma from July 1, 2013 to February 4, 2018 in southeast England, UK. All patients 60 years presenting with traumatic injury attended by the Kent, Surrey and Sussex Air Ambulance Trust (KSSAAT) were included. Results KSSAAT attended 6988 patients during the study period, 1499 patients (21.45%) met study inclusion criteria. Median age was 71 years (IQR 14) with 45.10% patients categorised in the 60-69 age band. Interrogated dispatch formed the highest proportion of activations (n= 575, 38.36%). As age increased, the volume of clinician requests increased to 50%. All-cause road traffic collisions were the most common mechanism of injury (n= 669, 44.63%). Falls <2 metres increased with age from 15.53% (60-69 years) to 34.85% (over 90 years). Head injuries were the most prevalent anatomical injury site; isolated head injuries (n= 374, 25.15%) versus poly-trauma (n= 617, 41.49%). Median presenting Glasgow Coma Score (GCS) was 14-15 (60-69 years) compared to 9 (over 90 years). Triage to a major trauma centre increased with age, 53.70% (60-69 years) to 66.08% (80-89 years). Conclusion This retrospective analysis supports the existing evidenced trend in older trauma. Helicopter Emergency Medical Services provide advanced interventions at the point of injury. Optimisation of clinical dispatch enables improved utilisation of the enhanced care team. Adoption of novel technological advances may improve dispatch and triage and support decision-making in older trauma.

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