1. GFR Training
Geriatric Patients

2. Geriatric Patients Where might GFR find geriatric patients? Professors
SUNY Geneseo Workers: Maintenance Staff, Cleaners, Construction Workers, etc…
Visitors at Geneseo: Family Members + Tours
Doty Community Room
Sporting Events
Geriatric Patients

3. Special Considerations for Geriatric Patients
Possibility of a long list of medications + medical history (be aware of blood thinners)
Ask if anything like this has ever happened before
Difficulty hearing: get down on their level
They might not be able to get up on their own if they fell: be gentle and consider using the backboard to assist with movement (help receiving agency)
Consider age related challenges

4. Occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients
Ischemic Stroke: 80% - arteries to the brain become narrow or blocked
Hemorrhagic Stroke: 20% - a blood vessel in the brain leaks or ruptures
Transient Ischemic Attack (TIA)- ”ministroke”. Temporary period of symptoms, no permanent damage BUT you are at a higher risk for a full blown stroke
Stroke

5. Stroke Symptoms Headache
Weakness/Tingling /Numbness (especially on one side of the body)
Facial Drooping
Altered Mental Status
Slurred Speech
Altered Sense of Vision, Hearing, Taste, Smell
Lack of Balance
Nausea
Seizures
Unreactive Pupils/Horizontal Deviation of the Eye*

6. Stroke BG Neurological Exam LAST KNOWN NORMAL BASELINE TIME ALS
Have the patient ready for immediate transport

7. Stroke Assessment Cincinnati Prehospital Stroke Scale:
Step #1: Have the patient repeat, “You can’t teach an old dog new tricks”
Step #2: Have the patient smile, assess for facial droop
Step #3: Have the patient close eyes and hold arms straight out for 10 seconds, assess for arm drift or unequal movement of one side
Stroke Assessment

8. Chronic Obstructive Pulmonary Disease (COPD)
Chronic Inflammatory Lung Disease (includes chronic bronchitis + emphysema)
Narrowed bronchioles, loss of elasticity of alveoli, thickened airway walls, production of mucus
Due to long term exposure to irritants (most common= cigarette smoke)
Chronic Obstructive Pulmonary Disease (COPD)

9. COPD Symptoms Coughing Mucus Production Wheezing Shortness of Breath
Chest Tightness
COPD Symptoms

10. COPD and Oxygen COPD can cause increased retention of carbon dioxide
Normal Homeostatic System: an increase in carbon dioxide causes individuals to breathe
COPD Patient (SOME) Homeostatic System: low oxygen levels drive respiration
SHORT TERM (EMS) oxygen administration can NOT harm a COPD patient. Oxygen therapy should be used when appropriate
COPD and Oxygen

11. COPD

12. Angina The term for chest pain caused by poor blood flow to the heart.
This could be caused by the buildup of thick plaques on the inner walls of arteries
Angina

13. Chest Pain- Possible Causes (Cardiac Related)
Myocardial Infarction (Heart Attack)- Damage or death of heart muscle that occurs when the blood flow in coronary artery, which brings blood and oxygen to the heart itself, is cut off completely (or severely reduced)
Coronary Artery Disease- A blockage in the heart blood vessels that reduces blood flow
Aortic Dissection-The inner layers of the aorta separate and the aorta can rupture
Pericarditis-Inflammation of the sac around the heart
Chest Pain- Possible Causes (Cardiac Related)

14. Other Possible Causes of Chest Pain
Digestive: Heartburn, GERD, Gallbladder/Pancreas Inflammation,
Muscle: Costochondritis, Injured Ribs
Lung: Pulmonary Embolism, Pleurisy, Collapsed Lung
Panic Attack
Shingles
Etc.
Other Possible Causes of Chest Pain

15. Types of Chest Pain Stabbing Crushing Squeezing Tightness Pressure
Radiating pain to left arm, back, jaw
Types of Chest Pain

16. Chest Pain

17. Fainting/Nausea/Dizziness
Our Role:
ABCs
Vitals
Appropriate Oxygen Therapy
SAMPLE + OPQRST
Make the patient comfortable
Keep the patient seated
Consider Possible Explanations (i.e. Chest pain, Stroke, COPD, Hyper/Hypoglycemia, etc..)
Fainting/Nausea/Dizziness

18. Our Role
ABCs
Consider appropriate immobilization: C- Spine or Extremity
Make the patient comfortable
Vitals, SAMPLE, OPQRST
Be aware that geriatric patients are fragile
Consider the reason for patient falling
Falls

19. Why Did The Patient Fall?
Tripping
LOC
Weakness/Tingling/Numbness
Pain
Low Oxygen Levels
Dizziness
Etc..
Why Did The Patient Fall?

20. Altered Mental Status: Possible Causes
Dementia/Alzheimer’s
Stroke
Head Injury
Alcohol/Drugs
Hyper/Hypoglycemia
Systematic Infections
Hypothermia/Hypothermia
Psychiatric Issues
Etc..
Altered Mental Status: Possible Causes

21. Evaluation of Altered Mental Status
Where are you?
What time of day is it?
What time is it?
How many quarters are in a dollar?
What is your name? – ask again later or check with bystander/license
Situational awareness- event
Look to bystanders for information
CAN NOT SIGN THE PATIENT OFF
Evaluation of Altered Mental Status

22. Questions???