Blunt chest trauma from falls or motor vehicle collisions are a common reason for ED visits and a common source of rib fractures. While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, with a focus on the risks in older adults.
We all know the population of the United States is aging. We know emergency physicians need to be prepared and trained to care for older adults. But how can you dive into the world of geriatric EM to learn more, to research, to gain additional training? In this post, we have gathered the wisdom of leaders in geriatric EM across the country, to share their recommendations, inspiration, and motivation.
60% of patients in the United States who develop severe sepsis are older adults (age 65 and over) , and the mortality of severe sepsis increases steadily with age to nearly 40% in those over 85 . There are many factors that make older adults more susceptible to sepsis, and that can also make sepsis more difficult to detect. Here are some tips to help explain why this is, and how you can identify it sooner.
“Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.” This statement was one of ACEPs 2013 Choosing Wisely recommendations. How palliative care can be effectively and practically integrated into the ED, and which patients are likely to benefit from it is still being worked out at many institutions.1–4 However, it is clear that the time for palliative care in the ED has come.
“Transitions of care” has become a hot topic in the care of older adults. It is usually applied to the transition from the hospital to home or the hospital to a nursing facility. But what about the transition from the ED to an inpatient service? It turns out there are plenty of things we could be doing (or not doing) to help smooth that transition and improve patient care. Here are some thoughts from admitting physicians with geriatrics training.
We are all familiar with the concept of pediatric EDs. We see them as medical students, we train in them as residents, and we work alongside pediatric EM fellows. It is generally clear what pediatric EDs have to offer: smaller sized beds and equipment, nurses trained in pediatric triage and assessment who know how to put IVs in babies and calm crying kids, and physicians with training in pediatric Emergency Medicine. But what about the other end of the age spectrum? Over the last 10 years geriatric EDs, also called Senior EDs, have been popping up around the country. You may have been wondering why that is, and what they have to offer. Here are a few thoughts.
It seems like a simple enough question: How do you diagnose and treat uncomplicated urinary tract infections (UTIs) in older adults? The answer is: It depends. In Part 1 of this post we discussed the diagnosis of UTIs in cognitively intact older adults and those with underlying cognitive impairment. This post will discuss treatment options.