Emergency medicine (EM) can safely manage geriatric trauma patients sustaining ground level falls: Fostering EM autonomy while safely offloading a busy trauma service

Limited data exists regarding different specialties care of geriatric (>74 years-old) trauma patients (GTPs). We created a “Tier-III” designation for ground-level fall (GLF) GTPs to be managed by EM, with a trauma consult as needed. A single-center comparison of PRE (1/1/2013-4/30/2016) versus POST (5/1/2016-11/30/2019) Tier-III GTP GLFs. The primary outcome was mortality. Secondary outcomes included admissions, trauma bay procedures and length of stay (LOS). 1,652 patients (314-PRE vs. 1,338-POST) were included. The admission rate was lower in the POST (56.9% vs. 88.9%, p 0.05). On multivariable analysis there was similar associated risk of mortality between groups (p = 0.68). The associated risk of mortality was similar between GLF GTP cohorts managed initially by EM and trauma surgeons, however the admission rate was lower in the POST group suggesting EM management may improve hospital bed utilization. •Limited data exists regarding triage of geriatric trauma patients (GTPs).•Management of ground-level fall (GLF) GTPs by emergency medicine (EM) and trauma is associated with similar risk of mortality.•GLF GTPs managed initially by EM had a lower rate of admission compared to those managed initially by trauma.