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Older Person's Trauma Care in an MTC ED: Two-Tiered Care. Is Perceived Lower Acuity the Problem?

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Lorena Lucioli1; Donna Peel2; Athena Abell3; Tara Frau4; Jamie Ferguson5; Holly O'Flanagan6
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Introduction: This process mapping compared the ED journey of patients aged ≥65 years with those <65 years presenting to the Royal Sussex County Hospital (RSCH), the Major Trauma Centre for Sussex. Methods: We conducted a retrospective snapshot audit of adult trauma patients (stratified into ≥65 and <65 year groups) presenting to RSCH ED September–October 2025. Eligible cases were identified via the local Trauma Database (Panda). Comparative statistical analysis was performed using Welch’s ANOVA. Results: Ninety patients were included (45 aged over 65 years; 45 aged under 65 years). Older
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A Quality Improvement Project: Evaluation and Improvement of Collateral History Taking in Older Adults

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F N Mohd Faudzi; S Barua; W M Chua
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INTRODUCTION: Collateral history is a vital component of comprehensive geriatric assessment. Accurate and structured information from relatives or carers is essential for safe and effective clinical decision-making. This project aimed to evaluate how consistently collateral histories are obtained for older individuals and whether all essential components are documented. METHOD: The first cycle was conducted in November–December 2024 and included 30 patients. A structured collateral history proforma was used to collect data under the headings: A – Ask what happened; B – Baseline; C – Carers
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Silver Trauma Assessments - What Do We Miss ?

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A Parmar1; E Greenwood1; M Walters1; Naomi Whitwham1; J Shoaib2; Z Yasir2
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Introduction Data from the Trauma Audit & Research Network (TARN) show that older adults now represent the majority of trauma admissions with frailty associated with an increased 30-day mortality. TARN highlights inequalities in care for patients aged >60 years, including delayed surgery and reduced senior input. This quality improvement project assessed whether older trauma patients receive a structured and thorough Emergency Department (ED) assessment in line with the HECTOR pro forma. Method A retrospective review of patients aged >65 years (n=50) presenting to Huddersfield Royal Infirmary

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Are we referring the right patients? Aligning Care of the Elderly referrals for older surgical admissions: 2-cycle QIP

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Natania Varshney1, Chimdi Ndukwe2
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Background Older adults admitted under General Surgery, particularly with head injury or rib fractures, commonly live with frailty and complex needs. Early Care of the Elderly (COTE) involvement enables comprehensive geriatric assessment and reduces avoidable harm, yet referrals are inconsistent and poorly targeted. Aim To assess and improve (1) referral of older general surgical inpatients who met locally agreed COTE criteria, and (2) alignment of referrals with those criteria. Methods Two retrospective audit cycles of General Surgery admissions aged ≥65 years at Tunbridge Wells Hospital were
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Areas for Improvement in the Treatment of Fall-Related Intracranial Bleeding in Older Adults

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I Camplisson* 1; E Dunlop* 2; S Young 2; R AbouElAdab 2; V Ahmad 2; C Morris 2; N Mecha-Kalu 2; A Chatterjee 3
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Complications arising from head injuries obtained during falls, particularly intracranial bleeds (ICBs), are a major cause of morbidity and mortality in older people. For older adults, the most common mechanism of injury leading to ICBs is falling, and up to 43% of those hospitalised for these fall-related bleeds experience long-term disability. This audit set out to determine the effect of adherence to local and national guidelines for older people with fall-related ICBs. We analysed clinical data pertaining to 84 people over the age of 65 (82.8 +- 8.50, 59.5% female) receiving care in the

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Areas for Improvement in the Treatment of Fall-Related Intracranial Bleeding in Older Adults

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I Camplisson* 1; E Dunlop* 2; S Young 2; R AbouElAdab 2; V Ahmad 2; C Morris 2; N Mecha-Kalu 2; A Chatterjee 3
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Complications arising from head injuries obtained during falls, particularly intracranial bleeds (ICBs), are a major cause of morbidity and mortality in older people. For older adults, the most common mechanism of injury leading to ICBs is falling, and up to 43% of those hospitalised for these fall-related bleeds iexperience long-term disability. This audit set out to determine the effect of adherence to local and national guidelines for older people with fall-related ICBs. We analysed clinical data pertaining to 84 people over the age of 65 (82.8 +- 8.50, 59.5% female) receiving care in the

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Improving Assessment and Management of Acute Agitation in Older Adults: A Quality Improvement Project at Royal Gwent Hospital

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K Ash1; M Paget1; A Shinn2; T Sivagnanam3
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Introduction Acute agitation is a common and challenging presentation among hospitalised older adults, often occurring in the context of delirium. While non-pharmacological strategies are first-line, antipsychotics or benzodiazepines may be required. However, these treatments carry significant risks, including falls, prolonged hospitalisation, and increased mortality. Guideline-concordant and legally compliant prescribing is therefore essential. At Royal Gwent Hospital, discrepancies between recommended practice and clinical care prompted a quality improvement project aimed at improving
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OPIC: Leicester Medical School's (LMS) Innovation Preparing Graduates for the Needs of Patients with Dementia in the Modern NHS

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R Breare 1; H Vallender 2; M McPartland 2; A Arya 1; M Lam 1; A Boyle 3
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Introduction The Chief Medical Officer’s (CMO) report ‘Health in an Aging Society’ (2023) states there is a rise in the prevalence of age-related conditions, such as dementia. This requires medical school curricula to shift to encompass a ‘new’ demographic within the modern NHS. Older Persons and Integrated Care (OPIC) was developed during a recent revision of the LMS curriculum to ensure local graduates are prepared for the realities of clinical practice, with the aim of improving graduates’ ability to recognise, assess and manage patients with dementia. Method OPIC is a six-week block

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Primary prevention of fragility fractures in general practice

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Sophia Moschkau1
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Introduction Management of fragility fractures was estimated to have cost the NHS £4.4 billion in 2022. As the incidence of fragility fracture is predicted to rise along with the increase in population over age 65 in the UK, primary prevention is a necessary avenue to reduce its economic, social, and environmental impacts. Current best practice in the UK suggests that any female aged over 65 and male over 75 is at high risk of osteoporosis and should be assessed for the need for prevention of fragility fractures, including a QFracture 10-year risk calculation. Management for those identified

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Improving Safe Opioid Prescribing in the Peri-Operative Period

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Vidhya Nair1, May Nyein Oo2, Theint Shwe Yi Win3, Myo Zaw4
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Background Data were collected in the older adults with neck of femur and distal femur fractures on Orthogeriatric wards, Leeds General Infirmary. Introduction Older adults undergoing surgery are particularly vulnerable to opioid-related harm due to age-related changes in pharmacokinetics, multiple morbidity, frailty, and poly pharmacy. Variation and inconsistency of peri-operative opioid relating to dose selection, complications and duration were identified resulting potentially avoidable complications including delirium, constipation, prolonged recovery times. Data from the first cycle
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Network analysis identifies age-specific clusters of multimorbidity, disability, social participation, and falls

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R BLASI1; D LEME2; M SANTOS1; M SANTIMARIA3; M PERRACINI1,4; C LIMA1; F BORIM1,4
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Introduction: The onset and coexistence of chronic diseases during aging are associated with adverse outcomes, including disability, restriction of social participation, and falls. Although chronological age is often treated as a confounding variable in epidemiological models, evidence remains limited on how multimorbidity patterns are structured across different age groups. This study aimed to identify clusters of multimorbidity and examine their associations with disability in instrumental activities of daily living (IADL), restriction of social participation, and falls across age groups
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Falls incidence and characteristics in bilateral vestibulopathy: relationships with age, concerns about falls and balance

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Meichan Zhu
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Introduction: Bilateral vestibulopathy (bilateral loss of vestibular function; BVP) significantly impairs balance, leading to an elevated falls risk. Age, balance performance and concerns about falling may further exacerbate these issues. This study describes fall incidence characteristics among people with BVP and relates these to age, concern about falling and objective balance performance. Method: 51 participants with BVP completed a standardised 12-month fall history questionnaire, the Falls Efficacy Scale–International (FES-I) and the Mini-BESTest to collect data on fall incidents, causes

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Evidence-Based Design Principles for Safer Stairs: The Role of Geometry, Surface Performance, and Visual Definition

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Tim Hayes & Dr Diane Luther
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Stair-related falls remain a major contributor to slip, trip and fall (STF) incidents across the built environment, representing a significant public health, legal, and economic challenge. Epidemiological data consistently show that stairs are a high-risk transitional element within buildings, with injuries frequently resulting from a combination of geometric inconsistency, inadequate visual definition, insufficient slip resistance, and suboptimal user support. This paper synthesises established research, regulatory guidance, and applied industry knowledge to examine the principal design and
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Older adults admitted to intensive care with traumatic brain injury experience inferior mobility outcomes: a service evaluation

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Fiona Howroyd 1 2, James Hodson 1, Niharika A Duggal 2, Zubair Ahmed 1 2, Jonathan Weblin 1
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Introduction The incidence of traumatic brain injury (TBI) in older adults requiring admission to the intensive care unit (ICU) is increasing. Early ICU mobilisation is recommended, however, the effect of age on mobilisation practices after TBI remains poorly understood. This service evaluation aimed to describe ICU mobilisation activity and outcomes by age in patients with TBI. Methods A single-centre retrospective service evaluation was conducted, including all adults admitted to the ICU with TBI between January 2022 and November 2024 (CARMS ID-22399). Demographics, ICU admission
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Developing a Scotland-wide, HECTOR course: Improving patient-centred care of older adults affected by major trauma in Scotland

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Emily Foster1; Sarah Turpin2; Laura Stewart3; Joel Burton4;Claire McLean5
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Introduction: HECTOR is a 2 day SIM based course that originated in Birmingham, and is designed to train healthcare professionals to deliver patient centred care for older people who have sustained traumatic injuries. Our goal was to develop "HECTOR Scotland" (an adapted course to fit Scottish guidelines) to allow those across the major trauma networks in Scotland to access the course, and to grow a Scotland based multi-disciplinary faculty. Method: The first HECTOR Scotland was delivered in March 2023, with an initial faculty of six (5 doctors and 1 nurse). Since then, 7 further courses have

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Reducing Falls through targeted Sarcopenia Management: Findings from an MDT Sarcopenia Clinic from Qatar

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 I MUNEEB 1; Dr Hanadi Al Hamad 1; AL ANOUD FEHAIDI 1; S KANNU1; S Khan 1
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Introduction: Sarcopenia is recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes such as decreased mobility, impaired standing balance, functional decline, Falls and Frailty. To address age related Sarcopenia, an MDT clinic was established in Rumailah hospital which brought expertise from Geriatricians, Physiotherapists and Clinical Dietitians. Methods: The Sarcopenia clinic enrolled older adults (>60 years) in the and assessments included SARC-F, handgrip dynamometry, frailty measurements, SPPB, TUG, and BIA. Interventions comprised CGA
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Improving inpatient falls reviews: a quality improvement project at the University Hospital

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K. Murray1, E.Mwenda2, S.Rees3, M. Devindan4
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Introduction Inpatient falls occur frequently with over 27,000 falls reported in Scottish hospitals annually (1). Inpatient falls can lead to adverse health-related outcomes and increased healthcare-related spending in older people. A thorough post falls assessment, as recommended by The World Falls Guidelines Task Force, is vital to characterise the fall and any preceding factors, ensure injuries are not missed and prevent further falls (2). Structuring medical records can improve patient outcomes and doctors’ performance (3). Our overall aim was to improve inpatient falls assessment and
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Evaluate Silver Trauma Risk Factors in Older People Undergoing CT Polytrauma

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S Siu 1; D Sebastian 1; V Shenoy Bellare 1; T Lewis 1; C Bronze 1; N Marriage 1
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Introduction Older people are at increased risk of significant injury following low-energy trauma and may present without physiological compromise. This can lead to under-recognition of injury and delayed management. The Norfolk and Norwich University Hospital (NNUH) Emergency Department uses an adopted Silver Trauma triage tool incorporating multiple clinical risk factors to guide senior review and CT polytrauma imaging. However, the predictive value of individual risk factors within this tool remains uncertain. This project aimed to evaluate the performance of individual risk factors in
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Hypomagnesemia: An Overlooked Cause of Delirium and Cardiac Complications in an Elderly Patient

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K CHERRY PHYO1; Z KYAW2; T THYN3
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Abstract Delirium is a frequent complication in elderly patients and is often multifactorial, with electrolyte imbalances representing a major contributor. While sodium, potassium, and calcium disorders are commonly evaluated, hypomagnesemia is an overlooked but clinically significant cause of both neurological and cardiac manifestations. Magnesium is essential for neuronal stability, neurotransmitter regulation, and calcium channel modulation. Its deficiency can lead to neuropsychiatric symptoms, arrhythmias, and myocardial injury. We report the case of an 81-year-old woman who presented with
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Implementing an Orthogeriatric Multidisciplinary Team Grand Round to Improve Multidisciplinary Care for Older Trauma patients

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T Idris1, P Sarda1, S Colman1, S Boswell1, D Moll1, R Ranadive2, G Pyakurel1
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Introduction Older adults admitted with femoral fragility fractures require coordinated multidisciplinary team (MDT) approach. On a 33-bed orthopaedic trauma ward with predominantly older people with frailty, MDT identified systemic challenges causing prolonged length of stay and suboptimal patient experience. Key issues included fragmented MDT processes, duplication between board rounds and ward reviews, delays in investigations and decision-making, inconsistent communication with patients and families, and frequent outlying of patients to other wards. Although national guidance emphasises
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