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Geriatric Emergencies is a practical guide to the common conditions affecting older patients who present in an emergency to hospital or primary care. Beginning with the essentials of history taking and clinical examination, the book covers a comprehensive range of emergencies, emphasizing the different management approaches which may be required in older patients. Common geriatric presentations such as falls, delirium and stroke, are explored in detail in addition to more diverse topics such as abdominal pain, major trauma and head injury. Ethical considerations such as advanced care planning, palliative care and capacity assessment are discussed with practical tips on communicating with patients and their relatives. Geriatric Emergencies provides concise up-to-date guidance to the emergency management of the older patient. It is a recommended resource for all health professionals working in the acute environment, in which a large proportion of patients are aged over 65.
This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.
This book discusses all important aspects of emergency medicine in older people, identifying the particular care needs of this population, which all too often remain unmet. The up-to-date and in-depth coverage will assist emergency physicians in identifying patients at risk for adverse outcomes, in conducting appropriate assessment,and in providing timely and adequate care. Particular attention is paid to the commonpitfalls in emergency management andmeans of avoiding them. Between 1980 and 2013, the number of older patients in emergency departmentsworldwide doubled. Compared with younger patients, older people suffer from more comorbidities, a higher mortality rate, require more complex assessment and diagnostic testing, and tend to stay longer in the emergency department. This book, written by internationally recognized experts in emergency medicine and geriatrics, not only presents the state of the art in the care of this population but also underlines the increasing need for adequate training and development in the field.
This book introduces the unique medical needs of aging patients in the emergency department and outlines the challenges that leave many clinicians struggling to adequately care for this demographic, including limited resources, management concerns, and other barriers. The text presents strategies for screening, diagnosing, and treating geriatric syndromes seen in the emergency care of the older adult patient. Topics include pharmacological interventions, transitioning care, and sustainability. The text includes complex cases that demonstrate the caution necessary to treat this delicate patient group. Each case concludes with a set of concise "take-home points" to make the guidelines easy to remember and/or reference. Geriatric Emergencies: A Case-Based Approach to Improving the Acute Care of Seniors is an excellent resource for geriatricians, emergency medicine specialists, internal medicine physicians, hospitalists, nurses, social workers, students, residents, trainees, and all medical professionals working with older patients in an emergency setting.
This volume, sponsored by the American College of Emergency Physicians, is a comprehensive, practical, ready-reference for the ED physician. Content focuses on how to effectively and accurately diagnose and treat this unique population. Each chapter is structured as follows: High Yield Facts: a bulleted list of 5 high yield facts Introduction: definition of problem and relevancy to older population Epidemiology (if applicable): scope, incidence/prevalence, mortality Pathophysiology: causative factors, predispositions, risk factors, mechanisms of disease process or injury, organ systems affected and disease course Clinical Features: chief complaint, presenting symptoms key historical information, physical examination including general appearance, vital signs, specific findings, and associated findings Diagnosis and Differential: laboratory findings and ancillary testing (including indications for same and also predictive value of such tests, differential diagnosis Emergency Department Care and Disposition: immediate management priorities (overview), initial ED management (to include both pharmacological and non-pharmacological care of the patient), subsequent care (if applicable). Can also include prognosis. Additional Aspects: complications, controversies, pitfalls, medical/legal issues, ethical issues, and costs
The elderly represent the fastest growing segment of the population in developed countries, reflected in the patient population presenting to EDs and hospitals. These patients more often than not have greater co-morbidities, more complicated workups and utilize more laboratory and radiologic services. This text is designed to teach emergency physicians how best to care for this specific demographic of patients. It addresses physiologic changes, high-risk conditions, and atypical presentations associated with elderly patients in the ED that result in frequent misdiagnosis or delays in diagnosis. It instructs the readers how best to care for elderly patients in order to minimize morbidity and mortality, addressing some of the difficult psychosocial issues that confront health care providers that care for elderly patients, such as psychiatric disease and end-of-life care. The utility of this text is not limited to emergency physicians, but it should be useful to all health care providers involved in the treatment of elderly patients with acute medical or surgical conditions.
Care for older adults in Emergency Departments (EDs) has historically been focused on acute medical conditions with little emphasis on geriatric-specific issues. In 2010, emergency departments (EDs) throughout the nation saw almost 130 million patients, 15% of whom were 65 or older. The number of older adults who visit an ED has doubled in the last decade and continues to grow rapidly. Older adults receiving care in an ED are highly likely to be admitted to the hospital, much more so than their younger counterparts. Preventing a hospital admission saves older adults from frequently encountered adverse events, including hospital-acquired delirium, functional status impairment, cognitive loss, and nursing home admission. It is unknown how many older adults are hospitalized for reasons other than acute medical illness, such as functional decline, polypharmacy, progressive dementia, caregiver stress, or unstable living situation. These non-emergent conditions are rarely addressed during a typical ED visit due to lack of resources, significant patient volumes, and the need for rapid turnover of care spaces. The predominant management strategy of emergency physicians to handle these important but not imminently life-threatening geriatric issues is to recommend hospital admission. Northwestern has pioneered the Geriatric Emergency Department through the creation of the Geriatric Emergency Department Innovation model (GEDI), with goals to prevent admissions for older adults by assessing and meeting their geriatric-specific, non-acute care needs in the ED. The GEDI model at Northwestern centers on a multi-disciplinary curriculum composed of clinical, didactic, and practical arms developed by emergency medicine and geriatrics educational experts. In this title, we will present case studies of older adults seen in the Emergency Department through the GEDI model and discuss means of identifying/screening for, diagnosing, and treating geriatric syndromes seen in the emergent care of the older adult patient. In addition, there will be a set of concise “take-home points” for each case study that will be easy to commit to memory and implement in clinical care of older adults. As the number of seniors seeking emergent care will continue to increase, the ED setting must become responsive to geriatric-specific needs. This book will provide a variety of models detailing how to offer comprehensive, state-of-the-art, optimal care for managing the full range of geriatric syndromes that regularly present in the emergent care setting.
An essential, experience-based, practical guide for anyone looking to improve the care of older patients in the emergency department.
The third edition of the definitive international reference book on all aspects of the medical care of older persons will provide every physician involved in the care of older patients with a comprehensive resource on all the clinical problems they are likely to encounter, as well as on related psychological, philosophical, and social issues.
Geriatric Emergencies is a practical guide to the common conditions affecting older patients who present in an emergency to hospital or primary care. Beginning with the essentials of history taking and clinical examination, the book covers a comprehensive range of emergencies, emphasizing the different management approaches which may be required in older patients. Common geriatric presentations such as falls, delirium and stroke, are explored in detail in addition to more diverse topics such as abdominal pain, major trauma and head injury. Ethical considerations such as advanced care planning, palliative care and capacity assessment are discussed with practical tips on communicating with patients and their relatives. Geriatric Emergencies provides concise up-to-date guidance to the emergency management of the older patient. It is a recommended resource for all health professionals working in the acute environment, in which a large proportion of patients are aged over 65.