Anticoagulated Trauma Patients: A Level I Trauma Center's Response to a Growing Geriatric Population
| Autor: | James R. Swegle, Sheryl M Sahr, Sherry D. Olson, Sarah K. Spilman, Richard A. Sidwell, Elizabeth A. Fuchsen, Mark D. Mason |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Poison control Occupational safety and health Midwestern United States 03 medical and health sciences 0302 clinical medicine Trauma Centers Injury prevention medicine Humans 030212 general & internal medicine Registries Aged Aged 80 and over Chi-Square Distribution business.industry Trauma center Anticoagulants Civil Defense 030208 emergency & critical care medicine Retrospective cohort study Emergency department Middle Aged Triage Geriatrics Emergency medicine Emergency Medicine Population study Accidental Falls Female business Emergency Service Hospital Platelet Aggregation Inhibitors |
| Zdroj: | The Journal of emergency medicine. 53(4) |
| ISSN: | 0736-4679 |
| Popis: | Injured older adults often receive delayed care in the emergency department (ED) because they do not meet criteria for trauma team activation (TTA). This is particularly dangerous for the increasing number of patients taking anticoagulant or antiplatelet (AC/AP) medication at the time of injury.The present study examined improvements in processes of care and triage accuracy when TTA criteria include an escalated response for older anticoagulated patients.A retrospective study was performed at a Level I trauma center. The study population (referred to as A55) included patients aged 55 years or older who were taking an AC/AP medication at the time of injury. Study periods included 11 months prior to the criteria change (Phase 1: July 2013-May 2014; n = 107) and 11 months after the change (Phase 2: July 2014-May 2015; n = 211). Differences were assessed with Kruskal-Wallis and chi-squared tests.More A55 patients received a full or limited TTA after criteria were revised (70% vs. 26%, p 0.001). Undertriage was reduced from 13% to 2% (p 0.001). The trauma center significantly decreased time to first laboratory result, time to first computed tomography scan, and total time in ED prior to admission for A55 patients arriving from the scene of injury or by private vehicle.Criteria that escalated the trauma response for A55 patients led to reductions in undertriage for anticoagulated older adults, as well as more timely mobilization of important clinical resources. |
| Databáze: | OpenAIRE |
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