Geriatric Emergency Medicine

Summary

Suitable for: SHOs and registrars in emergency medicine, general medicine, general surgery, orthopaedics and trauma

This course introduces participants to the key concepts involved in delivering high quality emergency care for the older adult. It consists of a series of small, interactive group workshops delivered by consultants in geriatric medicine and geriatric emergency medicine.

More older people in Ireland than ever before are attending emergency departments and healthcare services, and it is not uncommon for hospitals catering for unscheduled care to have over 50% of their beds accounted for by patients over the age of 65. These trends are in line with international figures and the British Geriatric Society has acknowledged the pressing need to address how older people are cared for over the first 72 hours of an emergency admission.

Attending hospital is associated with risk for older patients. Admission rates are higher for older people (over 50% in some areas for patients over 75), and older patients also stay in hospital longer than other patient groups. Many older patients suffer from complex comorbidities and frailty and are at high risk of adverse outcomes (including sepsis and pharmacological adverse events, but also delirium, falls and general deconditioning).

Working with older patients can be difficult for those working in emergency medicine; however, as our demographics change, it is becoming a more and more important part of our everyday work.

Course overview

Topics covered in this course include:

  • Confusion – a pragmatic approach in the ED
  • Older persons trauma care
  • What is frailty?
  • Communicating with patients and families
  • Managing aggression and agitation in the ED
  • Changes in physiology and pharmacology in older age
  • What can my patient do? Simple functional assessment
  • Wound management and pressure sores in fragile older skin
  • Falls in the ED
  • Managing challenging behaviour
  • Getting care right at the end of life

Learning outcomes

  • Understand and recognise frailty and its significance in prognosis and clinical decision-making
  • Identify triggers for delirium in older patients
  • Knowledge of the key physiological and pharmacological changes for the older patient
  • Enhance safe discharge decision-making by learning simple functional assessment strategies
  • Develop an approach to recognise and manage end of life care