Table 3.

Panel agreement (n = 21) on appropriateness of trauma care modifiers on arrival at emergency department for patients aged 65 years or more with major trauma

Trauma care modifier	Median importance	Round; disagreement index*
		1	2	3
Signs of head injury (e.g., altered mental status, headache, vomiting, scalp laceration or hematoma) in older patients with major trauma taking anticoagulants (e.g., warfarin or direct oral anticoagulant) should be a criterion for trauma team activation	9.0	0.75	—	—
A Glasgow Coma Scale score < 15 or evidence that the patient is not at his or her baseline mental status in older patients with major trauma should be a criterion for trauma team activation	7.0	2.26	0.65	—
A heart rate > 90 beats/min at any time should be a criterion for trauma team activation in older patients with major trauma	7.0	1.61	0.52	—
Older patients with major trauma should have a serum lactate and/or base deficit value obtained on hospital arrival	8.0	1.09	0.49	—
Following the primary and secondary survey, 12-lead electrocardiography should be obtained in all older patients with major trauma	9.0	1.56	0.01	—
Level of pain should be addressed as soon as possible in older patients with major trauma; when required, opioid analgesia should be administered according to weight-based dosing to prevent undertreatment of pain	9.0	1.09	0.49	—
A systolic blood pressure < 110 mm Hg at any time in older patients with major trauma should be a criterion for trauma team activation	7.0	2.26	2.55	0.65

^*< 1 = agreement, ≥ 1 = disagreement.