GERIATRICS! #Logan

ger·i·at·ric ˌ jerē ˈ atrik/ adjective 1. of or relating to old people, especially with regard to their health care. noun 1. an old person, especially one receiving special care

OVERVIEW Describe six physiological changes that occur with aging. Describe effective methods for communicating with geriatric patients. Describe the effects of the following illnesses and diseases on geriatric patients: Cardiovascular and respiratory disease; Neurological diseases; Gastrointestinal diseases; Altered mental status. Describe four trauma considerations that are unique to geriatric patients. Describe the general management of geriatric patients. Describe how to manage a geriatric patient with advanced directives.

SEVEN PHYSIOLOGICAL CHANGES THAT OCCUR WITH AGING 1.Sagging, stooping, drooping, not pooping 2.Neurological: brain changes, AMS and clinical depression common 3.Cardiovascular: Hypertension, changes in <3 rate and rhythm 4.Gastrointestinal: constipation, impaired swallowing, liver inefficiency 5.Musculoskeletal: Osteoporosis, arthritis common 6.Respiratory: cough power diminished, increased tendency for infection 7.Skin: Perspire less, tears easily, heals more slowly

EFFECTS OF THE FOLLOWING ILLNESSES AND DISEASES ON GERIATRIC PATIENTS: Cardiovascular and respiratory disease: hypertension, myocardial infarction, congestive heart failure. Neurological diseases: syncope, stroke. Gastrointestinal disease: abdominal emergencies, aneurysm, bowel obstruction, GI bleeding, peritonitis. Altered mental status: caused by infection, head injury, stroke, transient ischemic attack (TIA), and hypoglycemia.

MEDICATIONS SAMPLE Beta-blockers Calcium-channel blockers Diuretics Blood thinners

FOUR TRAUMA CONSIDERATIONS THAT ARE UNIQUE TO GERIATRIC PATIENTS 1.Falls: very common MOI (also slips, trips, stumbles, tumbles and eating sh*t) 2.Hip and pelvic fractures: often related to osteoporosis, significant associated bleeding common 3.Traumatic brain injury: concussions much more common, but often symptoms are hidden, so pay attention to LOR 4.Cervical spine injury: fracture patterns in the spine in seniors and especially C1-C2 injuries common, especially associated with head trauma

EFFECTIVE METHODS FOR COMMUNICATING WITH GERIATRIC PATIENTS Speak loudly and clearly Relate to them – topical suggestions? Avoid demeaning nicknames Be understanding, patient, normal

GENERAL MANAGEMENT OF GERIATRIC PATIENTS Geriatric patients are typically more challenging to manage than younger patients because: Medical histories Use of multiple medications Age-related physiological changes General fragility and occasionally poor attitude Also: delays in treatment may cause their condition to worsen more than would be expected for younger patients. As a result, geriatric patients often require more aggressive treatment to mitigate complications related to poor cardiac output, respiratory distress, blood loss, and/or shock.

QUESTIONS?