Title:
Audit of fall-related trauma care provision in patients >65 years in a tertiary hospital emergency department.
Problem:
Falls in older adults cause significant morbidity. Frailty, multimorbidity and reduced physiological reserve heighten vulnerability to injury from low-mechanism trauma. International silver trauma guidelines emphasise timely imaging and multidisciplinary geriatric assessment. This audit evaluates current practice for older adults presenting post-fall to identify gaps and improvement opportunities.
Design / Methods:
A prospective audit was conducted in July 2025 including adults aged ≥65 years who presented post-fall. Data were obtained from electronic patient records to measure quality of care provided against international standards for CT imaging of suspected intracranial injury and provision of Comprehensive Geriatric Assessment (CGA).
Practice Change:
Among N=101 participants (mean age 82.33), 75.25% lived at home and 77.23% had polypharmacy. Most patients (79.21%) were triaged as Australasian Triage Score (ATS) 3–4. Head CT was clinically indicated in 91.09%, and 10 patients (9.9%) had acute intracranial pathology, most commonly intracranial haemorrhage. CT wait times varied markedly by triage category, ranging from <1 hour for ATS 1 to >10 hours for ATS 4. Only 43.56% received an inpatient CGA. These findings are informing clinician education and development of optimised care pathways for older trauma patients.
Re-Audit:
Re-audit will address triage accuracy, documentation and CT access and timeliness.
Conclusions:
Timely cranial CT is critical for diagnosis and disposition in older ED fall-related trauma patients, underscoring the need for improved imaging pathways and geriatric assessment uptake.