Resuscitating the Critically Ill Geriatric Emergency Department Patient

Emerg Med Clin North Am. 2019 Aug;37(3):569-581. doi: 10.1016/j.emc.2019.04.002. Epub 2019 May 21.

Abstract

The emergency department resuscitation of the critically ill geriatric patient is challenging and can be fraught with peril. The anatomic and physiologic changes that occur with aging can significantly influence the recognition of critical illness and the logistics of resuscitation itself. This article discusses the relevant physiologic changes with aging, the effect of these changes on clinical manifestations of critical illness in older adults, and the core principles of resuscitation in this population, with specific attention to sepsis and trauma care. In addition, end-of-life care is also discussed.

Keywords: Airway; Cardiopulmonary resuscitation; End of life; Sepsis; Trauma; Triage.

Publication types

  • Review

MeSH terms

  • Aged
  • Cardiovascular Physiological Phenomena
  • Cognitive Dysfunction / complications
  • Critical Illness / therapy*
  • Emergency Medicine
  • Emergency Service, Hospital*
  • Frailty / complications
  • Geriatric Assessment
  • Glomerular Filtration Rate
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Immunosenescence
  • Mobility Limitation
  • Pain Management
  • Pharmacokinetics
  • Physical Examination
  • Respiratory Physiological Phenomena
  • Resuscitation*
  • Sepsis / diagnosis
  • Sepsis / therapy
  • Terminal Care
  • Water-Electrolyte Balance
  • Wounds and Injuries / complications
  • Wounds and Injuries / therapy

Substances

  • Hypnotics and Sedatives