553 Quality Improvement: The Implementation of Routine Tertiary Trauma Survey in all Trauma Patients Aged Over 60 Years in a Busy District General Hospital

Abstract Introduction Missed injury (MI) in trauma-patients is a widely reported phenomenon, with rates varying from 1.9-39%. Methods exist to reduce the incidence of MI’s such as tertiary-trauma-survey (TTS). Robust primary and secondary surveys should indeed identify all injuries facilitate management. However, for trauma patients, there remains an unwanted prevalence MI. We hypothesized addition TTS may MI District General Hospital (DGH) associated morbidity mortality; particular those aged >60. Method Patient notes 18 consecutive admissions >60 years were audited admission demographics, timing outcome primary, secondary, tertiary surveys, occult injury. The bundle was subsequently implemented inpatients Results In round, 11% (n = 2) had evidence within 36hr admission, reflective exceeding TARN criterion. now being utilised we expect see >98% compliance. Conclusions incorporated routine patient care Compliance will be re-audited; aiming opportunity missed morbidity.