Geriatric Trauma Triage: The Scope of the Problem
Volume 4 | Issue 2 | Article 7 - Collective Wisdom: Editorial | Trauma Series
Full TextIntroduction
The scene is a crowded Emergency Department (ED) triage corridor. Lined up among the patients, walking in or delivered by a queue of ambulances, there are three patients.
The Scene
- A 76-year-old woman presenting via ambulance after falling down a couple of steps. She is a retired teacher living independently at home with a past medical history of hypertension. Her last fall was over a year ago. She had no preceding symptoms, suffered no head strike, and had a full recall of events. She had a prehospital blood pressure of 90/60 but, with no intervention, it is now 105/62 and other observations are normal. She stood and transferred to the ambulance trolley and paramedics reported no identifiable injuries.
- A 91-year-old man and aged care facility resident with advanced dementia presents via ambulance after an unwitnessed fall. He has frequent falls and recently, monthly ED presentations. He has atrial fibrillation but isn’t anticoagulated. He has a heart rate of 135 and otherwise normal observations. Paramedics have not found any obvious injuries.
- An 82-year-old woman and another aged care facility resident with an unwitnessed fall. She has early dementia and was found on the ground with hypoactive delirium and an occipital scalp abrasion. She has hypertension and is anticoagulated for atrial fibrillation. She has normal observations and is in cervical spine precautions with paramedic concern for isolated head injury.