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.
1. GENERAL ASSESSMENT OF THE ELDERLY PATIENT Scott Wilber and Alison Southern 2. PHYSIOLOGIC CHANGES WITH AGING Robert Anderson and Kate D. Zimmerman 3. FUNCTIONAL ASSESSMENT Scott Wilber and Kirk Stiffler, MD, MPH 4. PHARMACOLOGICAL ISSUES (INCL POLYPHARMACY, DRUG INTERACTIONS) Jon Mark Hirshon, Denise Nassisi and Ruben E. Olmedo 5. CONFUSION AND ALTERED MENTAL STATUS (INITIAL ASSESSMENT, DDX) Maura Kennedy, Josh Joseph and Maura Kennedy 6. PSYCHIATRIC ISSUES (FOCUS: DEPRESSION, DEMENTIA, AND DELIRIUM) Maura Kennedy, Josh Joseph and Maura Kennedy 7. ABDOMINAL CONDITIONS: SURGICAL Maura Kennedy and Katren Tyler, MD 8. ABDOMINAL CONDITIONS: NON-SURGICAL Maura Kennedy and Katren Tyler, MD 9. BACK PAIN Ula Hwang and Michael Winters 10. HEADACHE Andrew Chang, Benjamin W. Friedman and Rebecca Nerenberg 11. DYSPNEA Robert Anderson, Siamak Moayedi and Mercedes Torres 12. EVALUATION OF CHEST PAIN Andrew Chang and Marianne Haughey 13. ACUTE CARDIAC DISEASE IN THE ELDER PATIENT (INCL MI, ETC) Andrew Chang and Susanne DeMeester 14. SYNCOPE Vaishal Tolia, Julie Watkins-Torrey, and Benjamin W. Friedman 15. STROKE AND TIA Vaishal Tolia, Julie Watkins-Torrey, MD, Roxanna Sadri, MD, Kama Guluma, MD 16. INFECTIONS (WITH SPECIAL EMPHASIS ON EARLY SEPSIS) Scott Wilber and Jason Ondrejka, DO 17. DIZZINESS AND VERTIGO Andrew Chang, Alessandro Cancelliere MD, PhD and Jonathan Edlow 18. WEAKNESS AND FUNCTIONAL DECLINE Scott Wilber amd (Mary) Colleen Bhalla, MD 19. FALLS Robert Anderson, Tania D. Strout and Robert Anderson 20. TRAUMA ISSUES (THIS WILL PERTAIN A BIT MORE TO MAJOR TRAUMA AND RESUS) Robert Anderson, Christopher R. Carpenter and Peter Rosen 21. SURGICAL CONSIDERATIONS IN THE ED Vaishal Tolia, Charles O'Connell MD, Davut Savaser, MD, and Colleen Campbell, MD 22. ONCOLOGIC EMERGENCIES Vaishal Tolia, Gabriel Wardi, MD Alexander Bromfiend, MD, Leslie Oyama, MD 23. ABUSE AND NEGLECT Jon Mark Hirshon, Michael Bond and Ken Butler 24. PAIN MANAGEMENT Ula Hwang and Teresita Hogan 25. ETHICAL ISSUES AND END OF LIFE CARE Jon Mark Hirshon, Philip Magidson and Jon Mark Hirshon 26. DISPOSITION, TRANSITIONS OF CARE Ula Hwang, Barbara Morano and Carmen Morano 27. THE GERIATRIC ED Jon Mark Hirshon, Philip Magidson, Elizabeth Couser and John Schumacher