Timothy F. Platts-Mills, MD, MSc, received his undergraduate degree from Harvard College, and his medical degree from the University of California, Los Angeles. He completed a four-year residency in emergency medicine at the University of California San Francisco-Fresno. After working full-time clinically for three years at the University of North Carolina at Chapel Hill, Dr. Platts-Mills completed a Masters of Science in Clinical Research from the UNC Gillings School of Global Public Health. He is currently an assistant professor in the Department of Emergency Medicine at UNC, with joint appointments in the Department of Anesthesiology, the Department of Medicine, and the Division of Geriatrics. He is the recipient of a K23 career development award from the National Institute on Aging; mentors for this award are Dr. Samuel McLean and Dr. Philip Sloane.
Dr. Platts-Mills’s career goal is to improve the quality of emergency care for older adults through research, research mentorship, and support of the larger community of geriatric emergency medicine researchers. Dr. Platts-Mills’s K23 research examines the determinants of persistent pain and functional decline after motor vehicle collision among older adults. The long-term goal of this work is to develop emergency department-initiated interventions to reduce morbidity due to persistent pain after motor vehicle collision in the elderly. A related area of research interest is improving patient education, and physician decision making regarding pharmacologic agents for the outpatient treatment of acute musculoskeletal pain in older adults. Dr. Platts-Mills’s research group is also developing a protocol to screen for elder abuse in the emergency department. Dr. Platts-Mills’s research depends upon a group of outstanding mentees, and he has received both teaching and mentoring awards for these productive collaborations. He also serves as a decision editor in geriatrics for Annals of Emergency Medicine.
Areas of Expertise (7)
Geriatric Emergency Medicine
Geriatric Medicine Research
Harvard College: AB, Environmental Science and Public Policy
University of California Los Angeles School of Medicine: MD
Gillings School of Global Public Health University of North Carolina at Chapel Hill: MSc, Epidemiology
- Fellow, American Board of Emergency Medicine
- Diplomate, American Board of Emergency Medicine
Timothy F. Platts‐Mills MD, MSc Christopher S. Evans MPH Jane H. Brice MD, MPH
Over the past four decades, increased prehospital care coverage and improved access to acute emergency and surgical care have substantially improved outcomes for trauma patients with severe or life‐threatening injuries.1 However, most trauma patients who receive emergency care do not have life‐threatening injuries and following emergency department (ED) evaluation can be safely discharged home.2 The limited number of trauma centers and the time and resources needed to access these centers, particularly for individuals living in rural areas,3 creates a challenge; at the scene of an injury, a decision must be made as to whether an individual needs trauma center care or can be safely evaluated in a local ED. This decision is made millions of times a year in the United States and falls largely on the shoulders of prehospital providers (paramedics and emergency medical technicians) and the emergency medical services (EMS) organizations that employ them. Although prehospital providers and EMS systems get this decision right in many cases, there is growing evidence that they often do not get it right for older adults. Undertriage of injured older adults, including inappropriate destinations and nontransportation, has been described throughout the United States and is associated with poor outcomes.4-6 In an attempt to fix this problem, many states have adopted trauma triage protocols with specific criteria for elderly adults to define which individuals need trauma center care. Of the 39 states with publicly available statewide EMS trauma triage protocols, 34 (87%) have criteria specific to older adults.7 Of these, 21 have adopted the 2011 Centers for Disease Control and Prevention field triage guidelines,8 which include the following age‐specific guidelines: the risk of injury and death increases after the age of 55, systolic blood pressure less than 110 mmHg might represent shock in individuals aged 65 and older, and low‐impact mechanisms (e.g., ground‐level falls) might result in severe injury in older adults. Some states, including Ohio, have adopted physiological, anatomic, and mechanism‐of‐injury criteria that rather than providing guidelines for who might be at greater risk, explicitly define which individuals need to be taken to a trauma center.9 Together, these recently instituted protocols create a series of natural experiments for understanding the effects of triage protocols on transportation destinations and outcomes.
Hwang U, Platts-Mills TF
Abstract Effective treatment of acute pain in older patients is a common challenge faced by emergency providers. Because older adults are at increased risk for adverse events associated with systemic analgesics, pain treatment must proceed cautiously. Essential elements to quality acute pain care include an early initial assessment for the presence of pain, selection of an analgesic based on patient-specific risks and preferences, and frequent reassessments and retreatments as needed. This article describes current knowledge regarding the assessment and treatment of acute pain in older adults.
Carpenter CR, Platts-Mills TF
Abstract Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care.