Frailty trauma

About the podcast

Clare Bosanko once again joins The PTN on an overview of frailty trauma.

Our national trauma triage tools were designed to identify injuries in high-energy trauma sustained by young adults with few or no comorbidities. However the vast majority of traumas in the UK are ‘low-energy’ mechanisms sustained by an older, multi-morbidity demographic. Our tools are good at detecting injury in the former group, but perform poorly in the latter group. Predicting injury from these patient is tricky and as of yet there is no triage tool that works with this group.

The podcast looks at these difficulties and tries to provide some advice on what best practice might look like for this patient group. We also discuss important complications seen in this group; notably occult injury, polypharmacy and the risk of coexisting medical events.

The frail population is one of the ‘special consideration’ groups identified by the NMTNG competencies (amongst others). All level 1 and 2 learning areas are listed in the show notes.

Frailty Trauma – ThePTN podcast

UK Trauma triage tools are built using data from high-energy trauma in young patients. However, the majority of trauma patients are older adults who suffer different injury patterns which are typically 'low-energy' mechanisms. This podcasts looks into some of the difficulties this poses and tries to offer some ways of working around these difficulties.

Learning areas covered:

Clinical assessment and management in special circumstances: frailty trauma

• The nurse/ AHP can outline the key
  considerations in the care of a frail patient
• Is able to demonstrate a high index of suspicion for injury in frail patients who may present for reasons other than obvious traumatic injuries
• Can articulate relevant Co-morbidities and associated polypharmacy that may affect the trauma assessment, of a frail patient
• Has an understanding of the possibility of medical event leading to injury in patient’s presentation, and has an awareness of the relevant test that may be required to investigate these episodes
• The Nurse /AHP Is able to discuss the physiological changes in the older or frail patient and its impact in trauma.
• Is able to undertake the Frailty Assessment using a suitable assessment tool to support considerations regarding escalation and transfer