Study finds triage system less sensitive to elderly victims
27 jan 2010-- Elderly people involved in motor vehicle crashes (MVCs) are often under-triaged and inappropriately treated for injuries that go undetected, according to a study in the January issue of the Journal of Emergency Nursing.
Jenelle M. Weber, R.N., of the Johns Hopkins Hospital in Baltimore, and colleagues conducted a review of 17 articles on geriatric trauma published between 2003 and 2009 to identify trends in the reporting of MVC-related injuries.
The researchers found that geriatric trauma resulting from MVCs was under-detected, which resulted in patients being inappropriately assigned to non-trauma centers. The existence of comorbidities compromised the accuracy of trauma assessments. Also, prehospital triage guidelines were less sensitive to older people versus younger people. Shock and head injuries were the leading causes of trauma-related mortality in elders, and the incidence of potentially fatal injuries, such as intracranial hemorrhage and spinal cord and thorax injuries, was higher than among younger victims.
"Detection of injuries in older adults involved in MVCs is likely to continue to be a challenge for emergency nurses," the authors write. "By remaining cognizant of the interaction between comorbid conditions, physiologic changes associated with aging, medications, and the most common patterns of traumatic injuries, emergency nurses will be well prepared to anticipate and recognize trauma in elderly MVC victims."