Use of Emergency Departments by Elder Patients: A Five ‐year Follow‐up Study

Strange, Gary R.; Chen, Edwin H.

doi:10.1111/j.1553-2712.1998.tb02688.x

Cited by 136 publications

(98 citation statements)

References 10 publications

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“…[4][5][6] In an environment that increasingly incentivizes flow and rapid management, emergency physicians (EPs) are required to rapidly assess older patients who can have atypical presentations of disease, cognitive impairment or multiple other chronic conditions, be on multiple medications, and have either inadequate social supports or multiple community-care providers. [4][5][6][7] Older patients are more likely to experience adverse events in the ED, 8 including iatrogenic injury, 9 missed diagnoses, 10 omitted treatments, [11][12][13] poor medical outcomes, 14,15 death, 16 functional decline, [17][18][19] prolonged stays, 16 necessity for a discharge to a higher level of care, 20 and repeat ED use. 21,22 A 1992 American study reported that EPs found it challenging to provide consistently high-quality care for older patients.…”

Section: Introductionmentioning

confidence: 99%

A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine

Snider

Melady

Costa

2016

CJEM

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Background: Geriatric patients represent a large and complex subgroup seen in emergency departments (EDs). Competencies in geriatric emergency medicine (EM) training have been established. Our objectives were to examine Canadian postgraduate year (PGY)-5 EM residents' comfort with the geriatric EM competency domains, assess whether Canadian EM residents become more comfortable through residency, and determine whether geriatric educational exposures are correlated with resident comfort with geriatric EM. Methods: A national, cross-sectional study of PGY-1 and PGY-5 Royal College EM residents was conducted to determine their comfort in geriatric EM clinical competency domains. Residents reported their level of comfort in satisfying each competency domain using a seven-point Likert scale. Residents were also asked about the location of their medical education as well as the type and number of different geriatric exposures that they had received to date. Results: Of the 141 eligible residents from across Canada, 77% (109) consented to participate. None of the PGY-1 EM residents and 34% (14) of PGY-5 EM residents reported that they were comfortable with all eight geriatric EM competency domains. PGY-5 EM residents were significantly more comfortable than PGY-1 EM residents. Residents reported a highly variable range of geriatric educational exposures obtained during training. No relationship was found between resident-reported comfort and the nature or number of geriatric exposures that they had received. Conclusion: Current Royal College EM residency training in Canada may not be adequately preparing graduates to be comfortable with defined competencies for the care of older ED patients.

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Section: Introductionmentioning

confidence: 99%

A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine

Snider

Melady

Costa

2016

CJEM

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“…Esto es debido a que, cuando se les compara con los jóvenes, se ha visto que presenta un mayor número de complicaciones, un mayor porcentaje de ingreso, refrecuentación e institucionalización o muerte tras el alta [13][14][15][16][17] .…”

Section: Nivel Bajo De Actividad Físicaunclassified

“…Además, es frecuente no encontrar un único diagnóstico sino que habitualmente encontraremos diferentes procesos clínicos independientes. Todo ello se traduce en la necesidad de evaluaciones médicas más prolongadas, con un mayor número de pruebas complementarias y consultas a otros especialistas, lo que contribuye a aumentar la estancia media en urgencias 5 y el número de ingresos 6 . De hecho, no es infrecuente el ingreso en salas de observación de los ancianos con quejas no específicas 21 .…”

Section: Valoración Del Paciente Geriátricounclassified

“…En el área de salud de Pamplona, el porcentaje de urgencias hospitalarias atendidas en la población anciana durante el año 2008 osciló, en función del centro hospitalario, entre 20 y el 40% del total (Tabla 1). Considerando que el paciente anciano se asocia a unas estancias más prolongadas en urgencias 5 y a un mayor porcentaje de ingresos 6 , el incremento progresivo de las visitas a urgencias en dicho sector poblacional puede tener un tremendo impacto en la presión asistencial de los SUH 2,3 .…”

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El paciente geriátrico en urgencias

Martín-Sánchez

Alonso

Merino

2010

Anales Sis San Navarra

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RESUMENLa demanda en la atención urgente ha ido creciendo progresivamente en los últimos años y este incremento es más acusado en la población anciana. Teniendo en consideración que el paciente anciano requiere evaluaciones más complejas con una mayor realización de pruebas complementarias y consultas a otros especialistas, estancias más prolongadas en urgencias y mayor porcentaje de ingresos, el progresivo envejecimiento poblacional puede llegar a repercutir seriamente en la presión asistencial de los servicios de urgencias hospitalarios (SUH).El paciente anciano de alto riesgo es vital detectarlo antes de asignarle una ubicación definitiva. Para ello, es importante instaurar un cribado entre los pacientes ancianos que acuden a urgencias con el fin de seleccionar a los que se van a beneficiar de una valoración geriátrica integral y así poder diseñar un plan específico de cuidados. La intervención urgente en el paciente geriátrico no debe afrontarse exclusivamente como un problema médi-co sino que debe tenerse en cuenta aspectos funcionales, mentales o sociales. Representa un reto para los SUH.En el presente artículo vamos a desarrollar diversos aspectos como la detección y la valoración del paciente geriátrico así como a establecer ciertas recomendaciones para el entorno de urgencias.Palabras clave. Emergencias. Geriatría. Fragilidad. Anciano. Valoración. ABSTRACTDemand in emergency care has been growing progressively in recent years and this increase is more pronounced in the elderly population. Taking into account that the elderly patient requires more complex evaluations with a greater requirement for complementary tests and consultations with other specialists, longer stays in the emergency ward and a greater percentage of admissions, the progressive ageing of the population might come to have a serious repercussion on hospital emergency departments.It is vital to detect high risk elderly patients before assigning them a definitive placement. For this purpose it is important to install a sieving process amongst elderly patients who attend the emergency department in order to select those that will benefit from a comprehensive geriatric assessment and thus be able to design a specific care plan. Emergency intervention in elderly patients should not be faced exclusively as a medical problem, but functional, mental or social aspects should be taken into account. This represents a challenge for emergency care.This article considers different aspects such as the detection and assessment of the geriatric patient, as well as establishing certain recommendations for emergency setting.

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“…Geriatrik hastalar daha ciddi sorunlarla acil servislere başvururlar; bu hastalarda ambulans kullanımı daha fazla, acil serviste ortalama kalış süresi ise daha uzundur (2)(3)(4)(5). Yaşlı hastalar genç hastalara oranla, hastaneye yatışta 2,5 kat, yoğun bakıma yatışta ise 5 kat daha fazla başvuruya sahiptirler (6).…”

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Geriatrik hastada akut karın ağrısına yaklaşım

Ersel¹

2014

Ege Tıp Dergisi

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Dünya nüfusunun hızla yaşlanması sonucu acil servislere karın ağrısı ile başvuran geriatrik yaş grubu hasta sayısı da hızla artmaktadır. Değişen fizyoloji, komorbid hastalıklar, iletişim güçlükleri, çoklu ilaç kullanımı, yaşlı hastalarda akut karın tablosunda tanı koymayı güçleştirmektedir. Bu güçlüklere karşın bir çok hastanın organ spesifik tanısı acil serviste konmaktadır. Geriatrik yaş grubundaki hastalarda karın ağrısı tablosunda altta yatan bir cerrahi patoloji olma olasılığı yüksektir. Bu nedenle geriatrik hastaların karın ağrılarında tetkik ve konsültasyon istemleri diğer hasta gruplarına oranla daha hızlandırılmış ve öncelikli olarak yapılmalı, tanı güçlüğü çekilen hastalarda yatış ile gözlem ön plana alınmalıdır.Anahtar Sözcükler: Acil servis, acil yaklaşım, akut batın, geriatrik hasta. Summary As a result of rapidly aging of the world's population, the number of patients admits with complaint of acute abdominal pain to the emergency deparments in the geriatric age group is increasing. Changing physiology, comorbid disorders, barriers to communication and polypharmacy makes it difficult to make diagnosis in elderly patients

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Use of Emergency Departments by Elder Patients: A Five ‐year Follow‐up Study

Cited by 136 publications

References 10 publications

A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine

A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine

El paciente geriátrico en urgencias

Geriatrik hastada akut karın ağrısına yaklaşım

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