Chapter 41Geriatric Medical Emergencies

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Overview

The Aging of Society Physiological Changes Associated with Aging Assessment of the Elderly Patient Transport General Medical Considerations Common Illnesses in the Elderly

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The Aging of Society

Fastest growing population in the US Health problems increase as one ages The elderly rely on EMS services more

than any other age group

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Physiological ChangesAssociated with Aging

Each organ system of the body shows signs of aging

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Neurologic

Decrease in the senses– Vision– Hearing– Taste– Smell

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Cardiovascular

Decrease in elasticity of vessels Higher blood pressures Narrowing of the vessels Heart pumps less efficiently

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Respiratory

Lung and muscle tissue decrease in elasticity The alveoli work with less efficiency

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Gastrointestinal

Loss of teeth Decrease in mobility of

the gastrointestinal tract

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Genitourinary

Loss of bladder tone Decline in kidney function

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Musculoskeletal

Loss of calcium content in bones Decrease in flexibility of joints Inflammation of joints

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Integumentary

Loss of subcutaneous fat and water content Loss of hair color and hair loss

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Assessment of the Elderly Patient

The steps are the same but some special considerations exist

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Scene Size-Up

Note the general living conditions of the elderly patient’s home

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Focused History and Physical Examination

Communication difficulties

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Transport

Changes in musculoskeletal and integumentary systems may make the elderly patient vulnerable to injury during transport

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Stop and Review

What physiologic changes are common as a person ages?

How does this affect a person’s health? How might this impact the EMT’s care?

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General Medical Considerations

Polypharmacy is the use of multiple medications by a single person

Medical conditions may become more prevalent as one ages

Altered presentation of disease Mistreatment of the elderly

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Stop and Review

Describe the problems that can occur with polypharmacy.

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Common Illnesses in the Elderly

Any illness can occur at any age; however, there are some illnesses that are more common in the elderly than in other populations

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Altered Mental Status

Dementia – Alzheimer’s disease

Delirium

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Stop and Review

What is the difference between delirium and dementia?

What are some causes of dementia? How should the EMT treat the patient

with dementia?

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Trauma

Injuries that may be survived by a younger patient may be fatal for the elderly

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Acute Myocardial Infarction

Cardiovascular risk increases as one ages Presentation is often not typical

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Additional Common Medical Complaints

Abdominal pain Infection Stroke Depression Alcohol abuse Undernutrition