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Older Patients Less Likely to Be Taken to Trauma Centers
Date:8/18/2008

not taken to a trauma center. Conversely, almost 50 percent of patients over the age of 65 were similarly undertreated.

A follow-up survey of 127 EMS workers and 32 medical personnel (including doctors, nurses, and medical students) revealed that the top three reasons for not transporting an older patient to a trauma center were: a lack of sufficient training for handling such patients (more than 25 percent); not knowing trauma protocols (12 percent); and potential age bias (just over 13 percent).

"So the hope now is to identify this blind-spot problem, so that we can maybe help EMS staff try to catch on and adjust their thinking and attitudes and, in turn, change their behavior," Chang said.

Dr. Ron M. Walls, chairman of the department of emergency medicine at Brigham and Women's Hospital in Boston, expressed some surprise at the study's conclusions.

"I think in general that most providers tend to worry more about the elderly and recognize that they are more at risk and want to get them better care," said Walls, who's also a professor of emergency medicine at Harvard Medical School. "And I have to say that I've certainly never seen any evidence of an elderly bias in my practice before -- here in Boston or elsewhere. So, it makes me wonder if there are other factors at play that the research didn't get at."

"For example, older people often have complex medical problems and very strong relationships with doctors at a particular center," Walls added. "So EMS providers might perfectly well decide to take an older patient to where they are best known, or even respond to a patient request to do so, whether or not that center is a trauma center."

Chang pointed out that since his study focused solely on patients with major trauma, it would be "highly unlikely that these patient would have been able, or have the time, to express any preference of care."

Walls said that, patient preference aside, no studie
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