Aims and Objectives The TARN report ‘Major Trauma in Older People’ found that older trauma are under-triaged, have fewer senior reviews and wait longer for imaging. Normal ageing physiology means that traditional trauma parameters may not trigger, resulting in underestimation of injury severity. We implemented a new Silver Trauma Triage Tool (STTT) to prompt clinicians to consider serious injuries in older patients with low-energy trauma. Having presented an initial audit the Scottish Emergency Medicine Conference 2024 we now report a post-implementation analysis.

Method and Design The STTT was designed to include all injured patients ≥ 65. Mechanism and physiological parameters were included along with specific anatomical injury triggers. The tool was designed to prompt early senior clinician discussions to determine placement and imaging.

The STTT was trialled across a 1-week period in December 2023 and implemented in April 2024. An early post-implementation analysis was conducted in May 2024 to evaluate tool usage, placement outcome and senior reviews, as well as times from arrival to assessment, analgesia and imaging.

Results and Conclusion 84 eligible patients were identified. The tool was used in 51 patients (61%), an improvement from 32.7% when in the previous audit. 37 of 51 (72%) patients with STTT had a senior input at triage compared with 2 of 33 (6%) when the tool was not used. The STTT changed placement of 5 patients (2 were moved to resus and 3 up-triaged to next to be seen).

There was no significant difference in times to assessment, analgesia or imaging, however these measures are confounded by multiple factors that will require a larger dataset to control for. We conclude that the introduction of a new trauma triage tool is feasible and can improve process measures. We hope to report outcome measures in a future analysis of a larger dataset.