Geriatric Emergency Medicine: Research Update - Tried and True to Somewhat new - PowerPoint PPT Presentation

Loading...

PPT – Geriatric Emergency Medicine: Research Update - Tried and True to Somewhat new PowerPoint presentation | free to view - id: 85113e-ZmFkN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Geriatric Emergency Medicine: Research Update - Tried and True to Somewhat new

Description:

Geriatric Emergency Medicine: Research Update - Tried and True to Somewhat new Jacques Lee MD, MSc, FRCPC – PowerPoint PPT presentation

Number of Views:71
Avg rating:3.0/5.0
Slides: 20
Provided by: Jacqu181
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Geriatric Emergency Medicine: Research Update - Tried and True to Somewhat new


1
Geriatric Emergency Medicine Research Update -
Tried and True to Somewhat new
Jacques Lee MD, MSc, FRCPC
2
Objectives
  • To review existing research literature on
    Geriatric Emergency Medicine
  • Tried and (probably) True
  • Somewhat New!
  • To finish before Christmas!

3
GEM Literature Search Methods
  • 1. Geriatric.m_titl.
  • 2. elder.m_titl.
  • 3. older.m_titl.
  • 4. senior.m_titl.
  • 5. 1 or 2 or 3 or 4
  • 6. Emergency.m_titl.
  • 7. (accidents and emergencies).m_titl.
  • 8. ER.m_titl.
  • 9. ED.m_titl.
  • 10. 6 or 7 or 8 or 9

11.5 and 10 323 12.Limit English Human 299
4
GEM Research Update Tried True
  • Important reviews
  • Grief et al. J Em Nurse 2003
  • Aminzadeh et al. Ann Em Med 2002
  • Samaras et al. Ann Em Med 2010

5
GEM Research Update Epidemiology Descriptive
Studies
  • Older patients
  • Higher users of ED
  • More Frequently arrive by Ambulance
  • More likely to be admitted
  • More likely to require Critical Care
  • More likely to develop delirium
  • More likely to die

6
GEM Research Update Epidemiology Descriptive
Studies
  • Older patients
  • Receive More Tests / More resources
  • Have longer ED lengths of stay
  • Less likely to understand discharge instructions
  • More likely to return for the same problem

7
GEM Research Update Epidemiology Descriptive
Studies
  • Emergency physicians with
  • Less experience
  • Less training
  • Lower pay
  • Higher perceived volume of older patients,
  • Associated with higher perceived burden of
    care 6

8
GEM Research Update Prediction and Screening
  • Good data on clinical prediction tools for use in
    the ED
  • ISAR
  • TRST
  • PERIL

9
GEM Research Update Prediction and Screening
  • Good data on clinical prediction tools for use in
    the ED
  • ISAR
  • TRST
  • PERIL

10
GEM Research Update Prediction and Screening
  • Any studies comparing screening tool? 10
  • Are screening tools being used? 11

11
GEM Research Update Prediction and Screening
  • Something New?
  • Any studies comparing screening tool? 10
  • Are screening tools being used? 11

12
GEM Research Update Interventions
  • McCusker J, Verdon J. Do geriatric interventions
    reduce emergency department visits? A systematic
    review..

13
GEM Research Update Interventions
  • Something New?
  • Courtney et al.12
  • 24 Weeks case management and customized exercise
    program
  • Cost Effective ? 13

14
GEM Research Update Delirium
  • Tried True
  • Delirium increases length of stay 14
  • Prolonged ED stay increases Delirium
  • Delirium is an independent risk factor for
    mortality
  • Delirium can takes months to clear and can be
    permanent

15
GEM Research Update Delirium
  • Something New?
  • Genetic markers for delirium predisposition?
  • Computerized testing for delirium?

16
References
  1. Grief CL. Patterns of ED use and perceptions of
    the elderly regarding their emergency care a
    synthesis of recent research. J Emerg Nurs. Apr
    200329(2)122-126.
  2. Aminzadeh F, Dalziel WB. Older adults in the
    emergency department a systematic review of
    patterns of use, adverse outcomes, and
    effectiveness of interventions. Ann Emerg Med Mar
    200239(3)238-247
  3. Samaras N, Chevalley T, Samaras D, Gold G. Older
    patient in the Emergency Department. Ann Emerg
    Med Sept 21056(3)261-269.
  4. Singal BM, Hedges JR, Rousseau E, et al.
    Geriatric patient emergency visits. Part I
    comparison of visits by geriatric and younger
    patients. Ann Emerg Med. 199221802-807.
  5. Hedges J, Singal B, Rousseau E. Geriatric patient
    emergency visits. Part II Perceptions of visits
    by geriatric and younger patients. Ann Emerg Med.
    July 199221((7))808-813.

17
References
  1. Schumacher JG, Deimling GT, Meldon S, Woolard B.
    Older adults in the Emergency Department
    predicting physicians' burden levels. Journal
    of Emergency Medicine. 200630(4)455-60.
  2. McCusker J, Bellavance F, Cardin S, Trepanier S,
    Verdon J, Ardman O. Detection of older people at
    increased risk of adverse health outcomes after
    an emergency visit the ISAR screening tool..
    Journal of the American Geriatrics Society.
    199947(10)1229-37.
  3. Meldon SW, Mion LC, Palmer RM, Drew BL, Connor
    JT, Lewicki LJ, Bass DM, Emerman CL. A brief
    risk-stratification tool to predict repeat
    emergency department visits and hospitalizations
    in older patients discharged from the emergency
    department.. Acad Emerg Med. 200310(3)224-32.

18
References
  1. Lee JS, Schwindt G, Langevin M, Moghabghab R,
    Alibhai SM, Kiss A, Naglie G. Validation of the
    triage risk stratification tool to identify older
    persons at risk for hospital admission and
    returning to the emergency department.. JAGS.
    200856(11)2112-7.
  2. McCusker J, Verdon J, Veillette N, Berg K, Emond
    T, Belzile E. Standardized screening and
    assessment of older patients in the emergency
    department a survey of implementation in
    Quebec.. Canadian Journal on Aging. 2007 cited
    200726(1)49-57.
  3. McCusker J, Verdon J. Do geriatric interventions
    reduce emergency department visits? A systematic
    review. J Geront Series A. 200661(1)53-62.

19
References
  1. Courtney M, Edwards H, Chang A, Parker A,
    Finlayson K, Hamilton K. Fewer emergency
    readmissions and better quality of life for older
    adults at risk of hospital readmission a
    randomized controlled trial to determine the
    effectiveness of a 24-week exercise and telephone
    follow-up program.. Journal of the American
    Geriatrics Society. 2009 cited 2009
    Mar57(3)395-402.
  2. Graves N, Courtney M, Edwards H, Chang A, Parker
    A, Finlayson K. Cost-effectiveness of an
    intervention to reduce emergency re-admissions to
    hospital among older patients.. PLoS ONE E-
    Resource. 20094(10)e7455.
  3. McCusker J, Cole MG, Dendukuri N, Belzile E. Does
    Delirium increase hsopital stay? JAGS,
    200351(11)
About PowerShow.com