Chapter 41 Geriatric Medical Emergencies

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 2 Overview  The Aging of Society  Physiological Changes Associated with Aging  Assessment of the Elderly Patient  Transport  General Medical Considerations  Common Illnesses in the Elderly

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 3 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

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 4 Physiological Changes Associated with Aging  Each organ system of the body shows signs of aging

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 5 Neurologic  Decrease in the senses –Vision –Hearing –Taste –Smell

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 6 Cardiovascular  Decrease in elasticity of vessels  Higher blood pressures  Narrowing of the vessels  Heart pumps less efficiently

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 7 Respiratory  Lung and muscle tissue decrease in elasticity  The alveoli work with less efficiency

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 8 Gastrointestinal  Loss of teeth  Decrease in mobility of the gastrointestinal tract

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 9 Genitourinary  Loss of bladder tone  Decline in kidney function

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 10 Musculoskeletal  Loss of calcium content in bones  Decrease in flexibility of joints  Inflammation of joints

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 11 Integumentary  Loss of subcutaneous fat and water content  Loss of hair color and hair loss

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 12 Assessment of the Elderly Patient  The steps are the same but some special considerations exist

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 13 Scene Size-Up  Note the general living conditions of the elderly patient’s home

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 14 Focused History and Physical Examination  Communication difficulties

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 15 Transport  Changes in musculoskeletal and integumentary systems may make the elderly patient vulnerable to injury during transport

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 16 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?

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 17 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

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 18 Stop and Review  Describe the problems that can occur with polypharmacy.

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 19 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

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 20 Altered Mental Status  Dementia –Alzheimer’s disease  Delirium

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 21 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?

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 22 Trauma  Injuries that may be survived by a younger patient may be fatal for the elderly

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 23 Acute Myocardial Infarction  Cardiovascular risk increases as one ages  Presentation is often not typical

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 24 Additional Common Medical Complaints  Abdominal pain  Infection  Stroke  Depression  Alcohol abuse  Undernutrition