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.
Table of Contents
List of Contributors vii
1 General assessment of the elderly patient 1
Alison Southern & Scott Wilber
2 Physiologic changes with aging 13
Kate D. Zimmerman & Robert S. Anderson, Jr.
3 Functional assessment of the elderly 28
Kirk A. Stiffler
4 Pharmacological issues in the elderly 43
Ruben Olmedo & Denise Nassisi
5 Altered mental status in the elderly 58
Josh Joseph & Maura Kennedy
6 Geriatric psychiatric emergencies 71
Josh Joseph & Maura Kennedy
7 Acute abdominal pain in the elderly: Surgical causes 83
Katren Tyler & Maura Kennedy
8 Nonsurgical abdominal pain in the elderly 99
Katren Tyler & Maura Kennedy
9 Back pain 110
Nicholas Santavicca & Michael E. Winters
10 Headache 123
Benjamin W. Friedman & Rebecca Nerenberg
11 Dyspnea in the elderly 139
Mercedes Torres & Siamak Moayedi
12 Acute chest pain in the geriatric patient 152
Marianne Haughey
13 Acute cardiac disease in elder patients 168
Susanne DeMeester
14 Syncope in Geriatrics 191
Timothy C Peck, Nissa J Ali & Shamai A Grossman
15 Stroke 203
Julie Watkins-Torrey, Roxanna Sadri & Kama Guluma
16 Infections 218
Jason Ondrejka & Scott Wilber
17 Dizziness and vertigo in the geriatric population 234
Jonathan Edlow & Alessandro Cancelliere
18 Weakness and functional decline 252
Colleen M McQuown
19 Emergency department evaluation of falls in the elderly 264
Tania D. Strout & Robert S. Anderson
20 Trauma in the geriatric patient 280
Christopher R. Carpenter & Peter L. Rosen
21 Surgical considerations in the elderly 304
Charles W. O’Connell, Davut Savaser & Colleen Campbell
22 Oncologic emergencies 321
Gabriel Wardi, Alexander Bromfield & Leslie C. Oyama
23 Elder abuse and neglect 351
Michael C. Bond & Kenneth H. Butler
24 Geriatric emergency pain management case 363
Teresita M Hogan & Alexandra Wong
25 Ethical issues and end-of-life care 386
Phillip D. Magidson & Jon Mark Hirshon
26 Geriatric dispositions and transitions of care 394
Barbara Morano, Carmen Morano, Kevin Biese, Eric A. Coleman & Ula Hwang
27 The geriatric ED, 407
Phillip D. Magidson, John G. Schumacher & Elizabeth A. Couser
Index 417
