title: Development of a geriatric resuscitation protocol, utilization compliance, and outcomes.
abstract: Inconsistent application of trauma service resources and underevaluation of risk and resuscitation status in elderly trauma patients are problematic. We describe a geriatric protocol that includes initial lactate determination and trauma surgery admission. Protocol compliance rates were initial lactate determination, 67.9%; trauma service admission for overt or compensated (elevated lactate) shock, 73.6%; and trauma service consultation for nonshock patients, 67.8%. Implementation of this protocol resulted in a trend toward reduced mortality and reduced potentially preventable deaths.
authors.affiliation: Trauma Services Department and Trauma Research Department, St Anthony Central Hospital, Denver, CO 80228, USA. pamelabourg@centura.org
authors.forename: Pamela
authors.initials: P
authors.lastname: Bourg
authors.forename: Melissa
authors.initials: M
authors.lastname: Richey
authors.forename: Kristin
authors.initials: K
authors.lastname: Salottolo
authors.forename: Charles W
authors.initials: CW
authors.lastname: Mains
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000451:nursing* / Q000592:standards*; D004632:Emergency Medical Services / Q000458:organization & administration / Q000592:standards; D016529:Emergency Nursing / Q000458:organization & administration / Q000592:standards*; D005853:Geriatrics / Q000458:organization & administration / Q000592:standards*; D019983:Guideline Adherence / Q000592:standards*; D017052:Hospital Mortality; D006801:Humans; D016134:Organizational Policy; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D017410:Practice Guidelines as Topic; D016730:Program Development; D012189:Retrospective Studies; D012769:Shock / Q000401:mortality / Q000451:nursing / Q000628:therapy; D014947:Wounds and Injuries / Q000401:mortality / Q000451:nursing / Q000628:therapy