Core EM - Emergency Medicine Podcast

Core EM - Emergency Medicine Podcast


Episode 208: Geriatric Emergency Medicine

April 15, 2025

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 Download Leave a Comment 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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