Prehospital Trauma Compendium: Management of geriatric trauma patients - A position statement and resource document of NAEMSP.

Publication/Presentation Date

9-12-2025

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.NAEMSP recommends:EMS clinicians should use age-adjusted, physiologic criteria to guide decisions to transport geriatric trauma patients to the most appropriate level of trauma center available in the community.Geriatric trauma patients should be promptly evaluated for pain and should receive analgesic interventions in a timely manner. Analgesic medications should be dosed following weight-based guidance and should be administered with consideration of potential drug interactions and age-related changes in drug metabolism and side effects.EMS clinicians should consult advance care planning documents, e.g., Physician Orders for Life-Sustaining Treatment (POLST), when available, to guide care in emergency scenarios, including management of traumatic injuries.While older patients are at higher risk for spinal injuries, including lumbar and cervical spine fractures, traditional spinal motion restriction practices may not be suitable for older patients due to age-related anatomic changes in spinal alignment and increased risk for cutaneous pressure-related injuries. EMS clinicians should exercise judgment to determine when and how to best achieve spinal motion restriction if spinal injury is suspected in geriatric trauma patients.

First Page

1

Last Page

18

ISSN

1545-0066

Disciplines

Medicine and Health Sciences

PubMedID

40939035

Department(s)

Department of Emergency Medicine

Document Type

Article

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