Background The use of ambulance services by older patients with injuries increases within the impacts of ageing-related changes leading to adverse patient outcomes. There is increasing recognition of the importance of prehospital trauma care for older patients, but little systematic research to guide practice. We aimed to review the published evidence on prehospital trauma care for older patients, determine the scope of existing research and identify research gaps in the literature. Methods A systematic scoping review guided by the Arksey and O’Malley framework reported in line with the PRISMA-ScR checklist. A systematic search was conducted of Scopus, CINAHL, MEDLINE, PubMed and Cochrane library databases to identify articles published between (2001-2021) years. Inclusion and exclusion criteria were applied independently by two reviewers. Data were extracted, charted and summarised from eligible articles. Results 65 studies were identified and reviewed, and 25 included. Five categories were identified: ‘field triage, ‘ageing impacts’, ‘decision-making’, ‘paramedic’ awareness’ and ‘paramedic’s behaviour’. Undertriage & overtriage (sensitivity & specificity) were commonly cited as poorly investigated field-triage subthemes. Ageing-related physiologic changes, comorbidities and polypharmacy were the most widely researched. Inaccurate decision-making and poor early identification of major injuries were identified as potentially influencing patient outcomes. More research is required into paramedic knowledge of geriatric care & ageing changes and the potential impact of paramedic care. Conclusion This is the first study reviewing the published evidence on prehospital trauma care for older patients and identifying research priorities for future research. This review has identified the prehospital triage for older trauma victims and studies of paramedic knowledge of older trauma care as key priorities. Investigating and understanding these can improve providing prehospital care of the older patient with injuries for positive patient outcomes.

中文翻译：

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PP15 老年受伤患者院前护理的研究重点：范围审查

背景 老年受伤患者对救护车服务的使用增加了与衰老相关的变化的影响，这些变化导致了不良的患者预后。人们越来越认识到院前创伤护理对老年患者的重要性，但很少有系统的研究来指导实践。我们旨在回顾已发表的关于老年患者院前创伤护理的证据，确定现有研究的范围并确定文献中的研究空白。方法 由 Arksey 和 O'Malley 框架指导的系统范围界定审查报告符合 PRISMA-ScR 检查表。对 Scopus、CINAHL、MEDLINE、PubMed 和 Cochrane 图书馆数据库进行了系统搜索，以确定 (2001-2021) 年间发表的文章。纳入和排除标准由两名评审员独立应用。从符合条件的文章中提取、绘制和总结数据。结果 65 项研究被确定和审查，其中 25 项被纳入。确定了五个类别：“现场分类、“老龄化影响”、“决策”、“护理人员”意识和“护理人员的行为”。分类不足和过度分类（敏感性和特异性）通常被认为是研究不足的现场分类子主题。与衰老相关的生理变化、合并症和多种药物是研究最广泛的。不准确的决策和对重大损伤的早期识别不力被认为可能影响患者的预后。需要对老年护理和老龄化变化的护理人员知识以及护理人员护理的潜在影响进行更多研究。结论 这是第一项审查已发表的老年患者院前创伤护理证据并确定未来研究的研究重点的研究。本综述将老年创伤受害者的院前分诊和老年创伤护理护理人员知识的研究确定为关键优先事项。调查和了解这些可以改善为受伤的老年患者提供院前护理，从而获得积极的患者结果。