Prehospital Trauma Compendium: Management of Geriatric Trauma Patients - A Position Statement and Resource Document of NAEMSP.

IF 2 3区医学 Q2 EMERGENCY MEDICINE

Prehospital Emergency Care Pub Date : 2025-09-25 DOI:10.1080/10903127.2025.2557006

William K Haussner, Amelia M Breyre, Kristen Bascombe, Whitney J Barrett, Mario A Camacho, Petter Overton-Harris, Samantha Williams, John W Lyng, Christian Martin-Gill, Christopher Colwell

引用次数: 0

Abstract

Trauma in geriatric patients (traditionally defined as adults aged 65 and older) is associated with high morbidity and mortality. Although older adults have lower average Injury Severity Scores (ISS) than younger patients, their mortality rates are higher. There are multiple hypotheses to explain these disparities; however, there is an incomplete consensus on how to best care for these patients in the prehospital setting. To address this issue, the National Association of Emergency Medical Services Physicians (NAEMSP) conducted a structured, rapid review of the literature to develop evidence-based guidance on the care of geriatric trauma patients in the prehospital setting.

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院前创伤纲要：老年创伤患者的管理- NAEMSP的立场声明和资源文件。

老年患者（传统上定义为65岁及以上的成年人）的创伤与高发病率和死亡率相关。尽管老年人的平均损伤严重程度评分（ISS）低于年轻患者，但他们的死亡率更高。有多种假设可以解释这些差异；然而，对于如何在院前环境中对这些患者进行最好的护理，目前还没有达成完整的共识。为了解决这一问题，全国急诊医疗服务医师协会（NAEMSP）对相关文献进行了结构化的快速回顾，以制定院前环境中老年创伤患者护理的循证指南。NAEMSP建议：EMS临床医生应使用年龄调整的生理标准来指导决定将老年创伤患者转移到社区中最合适的创伤中心。老年创伤患者应及时评估疼痛，并应及时接受镇痛干预。镇痛药物的给药应遵循以体重为基础的指导，在给药时应考虑到潜在的药物相互作用以及与年龄相关的药物代谢变化和副作用。紧急医疗服务系统的临床医生应参考预先的护理计划文件，例如，如有生命维持治疗医嘱（POLST），以指导紧急情况下的护理，包括创伤性损伤的处理。虽然老年患者脊柱损伤（包括腰椎和颈椎骨折）的风险较高，但传统的脊柱运动限制措施可能不适合老年患者，因为与年龄相关的脊柱排列解剖改变和皮肤压力相关损伤的风险增加。如果怀疑老年创伤患者有脊柱损伤，EMS临床医生应该判断何时以及如何最好地实现脊柱运动限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.30

自引率

12.50%

发文量

137

审稿时长

1 months

期刊介绍： Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.