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

Download One Comment Tags:

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

Read More

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
Podcast Episodes
Episode 161.0 – Opioid Epidemic [not-audio_url] [/not-audio_url]

Duration: 14:26
A look at the opioid epidemic and what ED providers can do to combat this formidable foe. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Opioid_Epidemic.mp3 Download Leave a Comment Tags: Opioid Dependence,…
Episode 160.0 – Measles [not-audio_url] [/not-audio_url]

Duration: 12:54
In this episode, we discuss the recent measles outbreak and how ED providers can best prepare to treat this almost vanquished foe. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Measles_Final_Cut.mp3 Downloa…
Episode 159.0 – Acute Decompensated Heart Failure [not-audio_url] [/not-audio_url]

Duration: 5:57
In this episode, we discuss acute decompensated heart failure and how to best manage these dyspneic patients in the ED. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_ADHF.mp3 Download Leave a Commen…
Episode 158.0 – Boxer’s Fracture [not-audio_url] [/not-audio_url]

Duration: 5:33
In this episode, we discuss Boxer's fractures and how to best manage them in the ED. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Boxer_s_Fracture_eq.m4a Download One Comment Tags: Orthopedics, Trauma Podc…
Episode 157.0 – Farewell [not-audio_url] [/not-audio_url]

Duration: 2:36
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_157_0_Final_Cut.m4a Download 5 Comments Read More
Episode 156.0 – Updates in Community Acquired Pneumonia [not-audio_url] [/not-audio_url]

Duration: 5:41
This week we dive into a recent article highlighting a major update in the treatment of community acquired pneumonia (CAP) https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_156_0_Final_Cut.m4a D…
Episode 155.0 – Journal Update [not-audio_url] [/not-audio_url]

Duration: 12:46
This week we discuss three recent articles looking at esmolol in refractory VF, c-spine clearance and antibiotics after abscess drainage https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_155_0_F…
Episode 154.0 – Femoral Shaft Fractures [not-audio_url] [/not-audio_url]

Duration: 5:32
This week we review femoral shaft fractures with a focus on assessment and analgesia https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_154_0_Final_Cut.m4a Download Leave a Comment Tags: Femoral…
Episode 153.0 – Morning Report Pearls VI [not-audio_url] [/not-audio_url]

Duration: 9:41
More amazing pearls from our Bellevue morning report series. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_153_0_Final_Cut.m4a Download Leave a Comment Tags: Alcohol Intoxication, Discitis,…
Episode 152.0 – Penetrating Neck Trauma [not-audio_url] [/not-audio_url]

Duration: 14:20
This week, we discuss penetrating neck trauma and some pearls and pitfalls in management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_152_0_Final_Cut.m4a Download One Comment Tags: Neck Tr…