REVIEW article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1588927
This article is part of the Research TopicInnovations and Strategies for Comprehensive Frailty Management in Older PeopleView all 7 articles
The Impacts of Ageing-Related Changes on Prehospital Trauma Care for Older Adults: Challenges and Future Directions
Provisionally accepted
- 1Jazan University, Jizan, Saudi Arabia
- 2The University of Sheffield, Sheffield, England, United Kingdom
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The ageing global population presents growing challenges for prehospital trauma care, particularly in addressing the complex needs of older adults. This narrative review explores the impacts of ageing-related anatomical and physiological changes on trauma care in the prehospital setting, with a focus on the challenges they pose for paramedic assessment, triage, and decision-making. These changes affecting the nervous, cardiovascular, respiratory, musculoskeletal, and renal systems that reduce physiological resilience and increase vulnerability to trauma, especially when compounded by frailty, polypharmacy, and comorbidities. The review highlights significant limitations in current trauma triage tools, which often lack sensitivity for identifying serious injuries in older adults and fail to incorporate frailty assessments. Although some protocols, such as the Ohio Trauma Triage Protocol, include geriatric adaptations, traditional tools continue to underperform, contributing to undertriage and suboptimal outcomes. Validated frailty assessment tools, including the Clinical Frailty Scale (CFS), PRISMA-7, and ISAR, offer promising potential for improving triage accuracy but are not yet routinely used in prehospital practice. Key gaps identified include insufficient paramedic education on ageing-related conditions, limited awareness of age-specific clinical presentations, and a lack of training in applying geriatric assessment tools. To address these issues, the review recommends integrating frailty screening into EMS triage, enhancing geriatric-specific training, and raising paramedic awareness of the physiological and clinical implications of ageing. Future research should investigate paramedics' behaviours, decision-making processes, and the feasibility of implementing frailty-based triage in the field. These strategies are essential to advancing prehospital trauma care and improving outcomes for the growing population of older trauma patients.
Keywords: Ageing changes, ageing impacts, Trauma, Prehospital care, older people
Received: 06 Mar 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Harthi, Goodacre and Sampson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Naif Harthi, Jazan University, Jizan, Saudi Arabia
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