Steven Atkinson – Emergencies in the Geriatric Patient

Outline

Identifying Vulnerability in Older Adults

• Common Underlying Chronic Illness
  • Arthritis, Hypertension, Heart Disease, Vision Loss
• Atypical Presentation of the Elderly
  • The Afebrile Septic Patient
  • The Lag-time with CXR’s
• Polypharmacy
  • Drug-Drug Interactions
  • The Top 10 Drugs to Avoid
• Nutritional Deficits
• Environmental Hazards and Falls
• Dementia vs. Delirium
  • The Take-Home Message You Shouldn’t Forget!

Neurological Emergencies

• Syncope – The “Million-Dollar” Work-Up
  • Causes: TIA, CVA, Vasovagal
• TIA: Why it can be Misleading
• Cerebrovascular Diseases
  • TIA vs. CVA
  • Assessment Tricks that Doctors Use
• Intracranial Hemorrhage
  • Assessment Tricks
  • The “Golden Hour”
• Seizures

Orthopedic Emergencies

• Major Orthopedic Fractures
  • Spine, Ribs, Pelvis, Femur
• Complications of Major Fractures
• Compartment Syndrome
  • Defined/Presentation/Treatment

Abdominal Emergencies

• GI Hemorrhage, Pancreatitis, Diverticulitis
• Bowel Infarction, Ectopic

Infectious Disease

• Bacteremia/Septicemia
• The “Never-Ending” UTI
• When to React
• Antibiotic Resistance

Cardiovascular Emergencies

• Cardiogenic Shock
• AMI/CHF Readmissions
• Acute Coronary Syndromes
  • Tropoinin, CK-MB and Other Lab Tests
  • Protocols and Outcomes
• Heart Failure
  • Presentation
  • DON’T Treat the Labs, Treat the Patient
• Cardiac Arrhythmias
  • Recognizing the Serious
  • Arrhythmias
• Venous Thromboembolic Disease
  • Differentiation
  • “Old-School” and “New-School” Treatments

Pulmonary Diseases

• Pulmonary Embolism
  • Watermark’s sign, Hampton’s Hump
  • The S1, Q3, T3 finding
  • “Old-School” and “New-School” Treatments
• Pneumonia
  • Viral Pneumonia
  • Diagnostic Tests

Renal Emergencies

• Electrolytic Disorders
• Acute Renal Failure
• Nephrolithiasis

Abuse and Neglect

• Risk Factors
• Clinical PEARLS: Don’t get Fooled
• Your Obligations / Involving Family