Episode 208: Geriatric Emergency Medicine
We explore the expanding field of Geriatric Emergency Medicine.
Hosts:
Ula Hwang, MD
Brian Gilberti, MD
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Geriatric_Emergency_Medicine.mp3
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Tags: Geriatric
Show Notes
Key Topics Discussed
* Importance and impact of geriatric emergency departments.
* Optimizing care strategies for geriatric patients in ED settings.
* Practical approaches for non-geriatric-specific EDs.
Challenges in Geriatric Emergency Care
* Geriatric patients often present with:
* Multiple chronic conditions
* Polypharmacy
* Functional decline (mobility issues, cognitive impairments, social isolation)
Adapting Clinical Approach
* Core objective remains acute issue diagnosis and treatment.
* Additional considerations for geriatric patients:
* Review and caution with medications to prevent adverse reactions.
* Address functional limitations and cognitive impairments.
* Emphasize safe discharge and care transitions to prevent unnecessary hospitalization.
Identifying High-Risk Geriatric Patients
* Screening tools:
* Identification of Seniors at Risk (ISAR)
* Frailty screens
* Alignment with the “Age-Friendly Health Systems” initiative focusing on:
* Mentation
* Mobility
* Medications
* Patient preferences (what matters most)
* Mistreatment (elder abuse awareness)
Minimizing Hospital-Related Harms
* Involvement of multidisciplinary teams:
* Social workers and care managers for care transitions
* Geriatric-certified pharmacists for medication review
* Coordination with outpatient services post-discharge
Implementing Geriatric Care in All EDs
* Basic geriatric care achievable even in resource-limited or rural EDs.
* Level 3 Geriatric ED Accreditation can be achieved through:
* Improved care transitions
* Staff education enhancements
* Age-friendly environments (comfort, nutrition, hydration)
Future of Geriatric Emergency Medicine
* Vision: Universal integration of geriatric-focused care.
* Goals:
* Enhanced patient experience
* Improved care transitions
* Alignment of treatments with patient goals
* Broader enhancement of emergency care quality for all patient populations
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