General Approach to EM Geriatrics
Generalized Approach to the Geriatric patient.
4 Basic Assessments.
- Common acute illness presents atypically - generalize weakness = MI or Hyponatremia
- Vital signs often normal in illness
- beta blocked, lack temperature
- Labratory studies often nornmal
- no leukocytosis
- Often consider polypharmacy
- assess memory and orientation; compare to baseline
- evaluate for deliruim
- important for assessing reliability of history and remembering dispo instructions
- Up to 3/4 of older patients present with chief complaint of functional decline
- ask about shortness of breath during episodes
- Basic ADLs
- walking, transferring, dressing, toileting
- get up and go test:ability to rise, ambulate 10 ft, turn around, and sit back down
- Instumental ADLs
- finances, taking medications, meal prep, driving
- Patients must be able to transfer and ambulate at a minimum to consider discharge by self
- who live with, family in town, anyone helps out?
- Living environment
- steps, hallways wide enough for walker, how far bathroom/kitchen from bedroom
ACEP Geriatric Video Series