Silver Trauma Clinic (STC)

The Silver Trauma Review Clinic is an ED clinic developed to provide a safety-net review service for frail patients > 65 who have suffered an injury and are being discharged from the ED following assessment and management of their injuries.

Suitable patients should be

• > 65

• Clinical frailty score > 2

The clinic will review:

• Stable Vertebral compression fractures

• Non operative pelvic fractures (pubic rami and sacral)

• Rib fractures

• Soft tissue injuries (occult fragility fractures)

• Non operative wrist/ankle injuries

• Mild TBI/concussion

The purpose of the clinic is to evaluate patients following frailty trauma with an aim to

• Assess for occult injury

• Identify and manage medical complications following injury

• Falls risk assessment

• Bone health assessment

• Rehabilitation programme development

We don't routinely see humeral fractures due to the complexity of this injury.

Cervical spine fractures should be referred to the spinal orthopedic service.

For wrist fractures requiring a full cast , we'll see them after the cast has been applied in fracture clinic and follow them up thereafter.

The clinic will run on Thursday afternoons from in the Injury Unit in Smithfield (first floor). Patient will be assessed by EM, Geriatrics and physiotherapy.

We have space for 4 new assessments each week and 4 reviews. Each visit takes about 1-2 hours.

Appointments can be made on patient centre, with a discharge to "Refer to ED clinic" and then SILVER TRAUMA REVIEW

The referral document and PIL are on the Mater FIT tab on patient centre.

Please ensure that patients have a full blood work up done including:

FBC, RENAL, LIVER, BONE profile, ESR, Vit D, VB12, Iron.

An ECG and documented postural BP should be performed.

Please ensure that patients receive a "Patient information Leaflet. The referral form should be completed and saved on patient centre.

Patients should attend with carers/NOK. Patient should bring a list of their medications, mobility aids, hearing aids and visual aids.

If it is unclear on suitability of referral or further questions please email silvertrauma@mater.ie

Here's a link to a talk given at medical grand rounds on Silver Trauma and preliminary data from the STC.