Episode 208: Geriatric Emergency Medicine

Episode 208: Geriatric Emergency Medicine

Author: Core EM April 15, 2025 Duration: 0:00

We explore the expanding field of Geriatric Emergency Medicine.

Hosts:
Ula Hwang, MD
Brian Gilberti, MD

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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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There’s a particular kind of pressure that comes with working in an emergency department, where decisions need to be both swift and sound. Core EM-Emergency Medicine Podcast exists in that space, offering a direct line to the essential knowledge and clinical reasoning that emergency medicine demands. Created by the team at Core EM, each episode feels less like a formal lecture and more like a focused conversation with a trusted colleague. You’ll hear discussions that break down critical topics, from managing common presentations to unraveling complex, high-acuity cases, all grounded in current evidence and practical reality. This podcast serves as a reliable resource for physicians, residents, and advanced practice providers looking to solidify their foundation or stay sharp on the latest evidence. It’s about cutting through the noise to deliver core content that’s immediately applicable at the bedside. Tune in for a clear, concise, and always relevant dive into the principles that define emergency care, designed to fit into a busy clinician’s life between shifts or during a commute.
Author: Language: en-us Episodes: 100

Core EM - Emergency Medicine Podcast
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