Geriatric Emergencies

March 2005

Geriatric Emergencies

After hearing a lecture at the Missouri Chapter of the American College of Emergency Physician’s annual meeting in August 2005 regarding “Geriatric Emergency Medicine 2005, The Year in Review: Ten Articles Which Should Change Your Practice”, you decide to analyze several of the articles yourself. Specific questions about which you wonder:

  1. Do the elderly represent a distinct population among adult patients? If so, how are they distinct and why should they be treated in a different manner than younger adults?
  2. With the image of the “demographic tsunami” represented by the unprecedented population of aging baby-boomers approaching us, are there measures which Emergency Medicine can undertake to improve the care of the elderly without compromising the care (or checkbooks) of other patients?
  3. What areas of patient care (diagnosis, prognosis, therapeutics, etc.) would you recommend we highlight as “research priorities” within Emergency Medicine over the coming decade? What question(s) would most impact your care of this population, if answered satisfactorily?

Years

First years: The effect of routine, early invasive management on outcome for elderly patients with non-ST-segment elevation acute coronary syndromes. Annals IM 2004; 141: 186-195.

Second years: Is intravenous recombinant tissue plasminogen activator (rt-PA) safe for use in patients over 80 years old with acute ischaemic stroke?-The Calgary experience. Age Ageing 2004; 33: 143-149.

Third years: Home hospitalization service for acute, uncomplicated first ischemic stroke in elderly patients: a randomized trial. JAGS 2004; 52: 278-283.

Fourth years: A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the Emergency Department-The DEED II Study. JAGS 2004; 52: 1417-1423.

Forms

All Residents: use the Therapy Critical Review Form

Articles

Article 1: The Effect of Routine, Early Invasive Management on Outcome for Elderly Patients with NSTE ACS, Annals IM 2004; 141: 186-195
ANSWER KEY

Article 2: Is Intravenous Recombinant Tissue Plasminogen Activator (rt-PA) Safe for Use in Patients Over 80 Years Old with Acute Ischaemic Stroke?- The Calgary Experience, Age Ageing 2004: 33: 143-149
ANSWER KEY

Article 3: Home Hospitalization Service for Acute Uncomplicated First Ischemic Stroke in Elderly Patients: A Randomized Trial, JAGS 2004: 52: 278-283
ANSWER KEY

Article 4: Home Hospitalization Service for Acute Uncomplicated First Ischemic Stroke in Elderly Patients: A Randomized Trial, JAGS 2004: 52: 278-283
ANSWER KEY