Geriatric Emergency Medicine by Sue Mason<\/p>\n
Sue Mason gives you her take on Geriatric Emergency Medicine.<\/p>\n
It is not a sexy topic and there are few gizmos and gadgets, but it is very important. How big is the problem? Patients over 65 years represent about a quarter of the patients that attend Sue\u2019s Emergency Department.<\/p>\n
Attendance and admissions in the elderly age group are both going up. What are we doing about it?<\/p>\n
Prehospital care has led the way with significant advances. For example, paramedics have been trained to assess and manage elderly falls. This found a reduction in ED attendance by 25% and decreased admissions by 6%.<\/p>\n
Approaching the management of the elderly with a multidisciplinary team has proved to be effective in a ward setting. However, this needs to be replicated in the Emergency Department. Within the ED there is potential for the inclusion of a pharmacist to improve admission rates. However, there has not been any other \u201cin department\u201d interventions involving a broader team.<\/p>\n
How can we do it better? Should we be training emergency physicians in Geriatric Medicine? Should there be sub-specialists in Geriatric Emergency Medicine?<\/p>\n
She also explores other strategies. Simple things such as not putting elderly patients on beds\/trolleys unless clinically indicated and ensuring they have fluids on board.<\/p>\n
Overriding all decisions should be the question \u2013 does this patient need this investigation, treatment, and admission.<\/p>\n