(1781) Improving Care of Geriatric Trauma Patients Through Trauma Team Activation and Protocol Compliance

Introduction: Altered physiologic response, multiple comorbidities, and polypharmacy contribute to the increased mortality rate of geriatric trauma patients compared to their younger counterparts. The American College of Surgeons recommends geriatric trauma patients undergo rapid triage via trauma team activation and treatment based on Geriatric Trauma Management Guidelines. This performance improvement project set forth to enhance the treatment of geriatric trauma patients by instituting a new trauma team activation and facilitating compliance with the existing Geriatric Trauma Guidelines at an urban Level II trauma center.

Methods: A Level 2 Geriatric Trauma Team activation was implemented based on current Level 2 criteria activation and additional vital sign criteria. Data regarding protocol compliance was obtained from the trauma registry and analyzed pre and post implementation. Staff knowledge and confidence in the care of geriatric trauma patients was measured. Paired samples t tests and X2 tests were utilized in data analysis.

Results: A total of 213 Geriatric Trauma Team Activations occurred with 116 requiring admission. Staff knowledge and confidence in caring for geriatric trauma patients improved. Over triage rates were insignificant, but under triage rates decreased. Time to completion of CT head for patients on anticoagulation decreased by 28 minutes. Time to completion of all CT scans decreased by 2 minutes. Lactic acid/base deficit draws decreased post implementation. Hospital length of stay decreased by 13 hours and 55 minutes.

Conclusions: The combination of a geriatric trauma team activation and staff education regarding geriatric trauma patients yielded improvements in care for this population.