Core EM - Emergency Medicine Podcast

Episode 208: Geriatric Emergency Medicine
We explore the expanding field of Geriatric Emergency Medicine.
Hosts:
Ula Hwang, MD
Brian Gilberti, MD
- Importance and impact of geriatric emergency departments.
- Optimizing care strategies for geriatric patients in ED settings.
- Practical approaches for non-geriatric-specific EDs.
- Geriatric patients often present with:
- Multiple chronic conditions
- Polypharmacy
- Functional decline (mobility issues, cognitive impairments, social isolation)
- 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.
- 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)
- Involvement of multidisciplinary teams:
- Social workers and care managers for care transitions
- Geriatric-certified pharmacists for medication review
- Coordination with outpatient services post-discharge
- 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)
- 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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