You may want to print out this article to show the paramedics if your elderly mother falls down the stairs.

A 10-year review of records for all transports of major trauma patients in Maryland found that people age 65 and older were less than half as likely to be taken to a designated trauma center than were those under 65.

The study of 26,565 priority I trauma patients between 1995 and 2004, led by researchers at Johns Hopkins, noted that current guidelines call for injured elderly patients to be treated just as aggressively as younger patients, and that studies have found the majority of them return home after a hospital stay.

In followup surveys, inadequate training in the management of elderly trauma cases was the most common reason given by 166 paramedics and other transport crews for not taking the most serious elderly patients to designated centers. Other reasons given were a lack of familiarity with the protocol, transport wasn't worth it because of the patient's age, and personnel in the trauma centers' emergency rooms would not welcome them with elderly patients.

A re-examination of the data using different age categories found a lesser dropoff in trauma center transports for patients between 50 and 69 years old. "These observations suggest that currently young may be defined socially as those younger than 50 years, while old may be defined as age 70 years or older," the authors write in yesterday's Archives of Surgery.