FOI 26-350 Clinical Triage of Critically Injured Patients >65
Freedom of Information Request
- Reference
- FOI 26-350 Clinical Triage of Critically Injured Patients >65
- Request Date
- 07 Aug 2026
- Response Date
- 14 Aug 2026
- Information Requested
This request relates to any prehospital clinical decision-making or triage tool used, or previously used, by your service specifically for the assessment, triage, or trauma centre conveyance decision-making of traumatically injured adult patients aged 65 and over (sometimes referred to as "silver trauma").
Questions Does your service currently use a distinct clinical decision-making or triage tool, guideline, or algorithm, whether standalone or as an adjunct/modification to a standard major trauma triage tool, specifically for assessing or triaging traumatically injured patients aged 65 and over?
Please answer yes or no.
If yes to Question 1, please provide a copy of the current version of this tool, guideline, or algorithm, including any accompanying operational guidance issued to clinicians.
Please state the date this tool, guideline, or algorithm was introduced or last formally reviewed/updated.
Please indicate whether this tool was developed internally by your service, adopted or adapted from a regional trauma network or Operational Delivery Network (ODN), or adopted from a national source (for example NICE, JRCALC, or another named source).
Please name the source where applicable.
If your service does not use a distinct tool for patients aged 65 and over, please confirm whether standard adult major trauma triage criteria (for example your major trauma triage tool used for trauma centre conveyance decisions) are applied without age-specific modification to this population.
Please provide a copy of your service's current major trauma triage tool or protocol used to determine conveyance to a trauma unit versus a major trauma centre, irrespective of patient age, if this has not already been provided in answer to
Question 2. Does your service's triage tool or guidance for patients aged 65 and over (or standard tool, if no distinct version exists) include any of the following modified thresholds or additional criteria compared with the standard adult tool?
Please answer yes/no for each and provide the relevant threshold where applicable.
- a) An adjusted systolic blood pressure threshold for hypotension in older adults
- b) An adjusted or age-specific Glasgow Coma Scale threshold
- c) A specific criterion relating to anticoagulant or antiplatelet medication use
- d) A frailty assessment or frailty scorecomponent
- e) A specific criterion relating to ground-level falls or low-energy mechanism of injury
Does your service collect or hold data on prehospital under-triage or over-triage rates specifically for patients aged 65 and over? If so, please provide the most recent summary data or report available, or confirm that this would require a separate request.
Does your service provide specific training to operational staff (paramedics, emergency care assistants, or equivalent) on the assessment or triage of traumatically injured patients aged 65 and over, distinct from standard major trauma training? If yes, please briefly describe the format (for example e-learning module, face-to-face session, clinical guideline circulation) and, if readily available, provide any associated training material.
- Response
Does your service currently use a distinct clinical decision-making or triage tool, guideline, or algorithm, whether standalone or as an adjunct/modification to a standard major trauma triage tool, specifically for assessing or triaging traumatically injured patients aged 65 and over?
Please answer yes or no.
No.
If yes to Question 1, please provide a copy of the current version of this tool, guideline, or algorithm, including any accompanying operational guidance issued to clinicians.
Please state the date this tool, guideline, or algorithm was introduced or last formally reviewed/updated.
Please indicate whether this tool was developed internally by your service, adopted or adapted from a regional trauma network or Operational Delivery Network (ODN), or adopted from a national source (for example NICE, JRCALC, or another named source).
Please name the source where applicable.
N/A
If your service does not use a distinct tool for patients aged 65 and over, please confirm whether standard adult major trauma triage criteria (for example your major trauma triage tool used for trauma centre conveyance decisions) are applied without age-specific modification to this population.
Please provide a copy of your service's current major trauma triage tool or protocol used to determine conveyance to a trauma unit versus a major trauma centre, irrespective of patient age, if this has not already been provided in answer to.
Our standard Major Trauma Triage Tool (MTTT) criteria are applied without age specific modification. However, "Age>55" is a specific trigger in Step 4 of our adult MTTT
A copy of the current adult MTTT has been attached as requested. Please note, this is due to be reviewed by the Scottish Trauma Network in 2026.
A direct operational telephone number has been redacted under section 30(c) of FOISA, as disclosure would be likely to prejudice substantially the effective conduct of public affairs by creating a risk of disruption to operational communications.
Question 2. Does your service's triage tool or guidance for patients aged 65 and over (or standard tool, if no distinct version exists) include any of the following modified thresholds or additional criteria compared with the standard adult tool?
Please answer yes/no for each and provide the relevant threshold where applicable.
- a) An adjusted systolic blood pressure threshold for hypotension in older adults
No
- b) An adjusted or age-specific Glasgow Coma Scale threshold
No
- c) A specific criterion relating to anticoagulant or antiplatelet medication use
No - However, as you will see, 'Bleeding Disorder or Anticoagulant Treatment' is a specific trigger on Step 4 of our MTTT irrespective of patient age
- d) A frailty assessment or frailty scorecomponent
No
- e) A specific criterion relating to ground-level falls or low-energy mechanism of injury
No
Does your service collect or hold data on prehospital under-triage or over-triage rates specifically for patients aged 65 and over? If so, please provide the most recent summary data or report available, or confirm that this would require a separate request.
No
Does your service provide specific training to operational staff (paramedics, emergency care assistants, or equivalent) on the assessment or triage of traumatically injured patients aged 65 and over, distinct from standard major trauma training? If yes, please briefly describe the format (for example e-learning module, face-to-face session, clinical guideline circulation) and, if readily available, provide any associated training material.
No
- Response Documents
