Effects of New Silver Trauma Criteria and the National Chest Injury Guideline on Demographics, Regional Analgesic Use and Length of Stay in Chest Trauma Patients
Presenter: Dr Kasia Hunt, Emergency Medicine Specialist, Te Whatu Ora MidCentral
Authors List
Hunt, K. M. Palmerston North Hospital, Palmerston North, New Zealand
Rider, S. Palmerston North Hospital, Palmerston North, New Zealand
Introduction
Geriatric and chest trauma management are international priorities in trauma care. In June 2025, Palmerston North Hospital (PNH) introduced Silver Trauma Criteria, followed in July by a National Chest Injury Guideline, recommending earlier identification of geriatric trauma and rib fracture severity, alongside regional analgesic strategies.
Aims
To investigate trends in demographics and pain management of patients hospitalised with chest trauma at PNH in relation to new focussed trauma pathways.
Methods
PNH trauma data between 1 January 2025 and 31 December 2025 were retrospectively analysed. Eligible patients (n=195) were patients admitted with rib and/or sternal fractures, plus any associated injuries.
Results
The median age of admitted patients increased significantly across the year, from 55.5 years in Q1 to approximately 70 years in Q4 (overall p = 0.018), while median hospital length of stay remained stable (p = 0.65). The sex distribution shifted toward greater gender parity. The proportion of females increased from 38.5% in Q1 to approximately 49% in Q4, although this change was not statistically significant (p = 0.13). ESB utilization showed an increasing trend, rising from 25% of patients in Q1 (n = 10) to 45% in Q4 (n = 23) (p = 0.18). In contrast, median duration of ESB use decreased from 118.5 hours in Q1 to 97 hours in Q4, although this change did not reach statistical significance (p = 0.82).
Conclusions
We attribute these findings to the two trauma guidelines. Despite increasing patient age, hospital length of stay remained unchanged, potentially reflecting improved early identification and analgesic management.
References
Health New Zealand National Chest Trauma Guideline. https://static.info.content.health.nz/docs/Chest%20Injury%20Guideline.pdf. Accessed July 2026.
Silver Trauma Criteria Palmerston North Hospital. Accessed July 2026.
Hunt, K. M. Palmerston North Hospital, Palmerston North, New Zealand
Rider, S. Palmerston North Hospital, Palmerston North, New Zealand
Introduction
Geriatric and chest trauma management are international priorities in trauma care. In June 2025, Palmerston North Hospital (PNH) introduced Silver Trauma Criteria, followed in July by a National Chest Injury Guideline, recommending earlier identification of geriatric trauma and rib fracture severity, alongside regional analgesic strategies.
Aims
To investigate trends in demographics and pain management of patients hospitalised with chest trauma at PNH in relation to new focussed trauma pathways.
Methods
PNH trauma data between 1 January 2025 and 31 December 2025 were retrospectively analysed. Eligible patients (n=195) were patients admitted with rib and/or sternal fractures, plus any associated injuries.
Results
The median age of admitted patients increased significantly across the year, from 55.5 years in Q1 to approximately 70 years in Q4 (overall p = 0.018), while median hospital length of stay remained stable (p = 0.65). The sex distribution shifted toward greater gender parity. The proportion of females increased from 38.5% in Q1 to approximately 49% in Q4, although this change was not statistically significant (p = 0.13). ESB utilization showed an increasing trend, rising from 25% of patients in Q1 (n = 10) to 45% in Q4 (n = 23) (p = 0.18). In contrast, median duration of ESB use decreased from 118.5 hours in Q1 to 97 hours in Q4, although this change did not reach statistical significance (p = 0.82).
Conclusions
We attribute these findings to the two trauma guidelines. Despite increasing patient age, hospital length of stay remained unchanged, potentially reflecting improved early identification and analgesic management.
References
Health New Zealand National Chest Trauma Guideline. https://static.info.content.health.nz/docs/Chest%20Injury%20Guideline.pdf. Accessed July 2026.
Silver Trauma Criteria Palmerston North Hospital. Accessed July 2026.
