Resuscitating the Critically Ill Geriatric Emergency Department Patient

• Published in: Emergency medicine clinics of North America Vol. 37; no. 3; pp. 569 - 581
• Main Authors: Khoujah, Danya, MBBS, Martinelli, Ashley N., PharmD, BCCCP, Winters, Michael E., MD, MBA
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2019
• Subjects: Aged; Airway; Cardiopulmonary resuscitation; Cardiovascular Physiological Phenomena; Cognitive Dysfunction - complications; Critical Illness - therapy; Emergency; Emergency Medicine; Emergency Service, Hospital; End of life; 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; Sepsis - diagnosis; Sepsis - therapy; Terminal Care; Trauma; Triage; Water-Electrolyte Balance; Wounds and Injuries - complications; Wounds and Injuries - therapy; Sepsis; Triage; End of life; Trauma; Airway; Cardiopulmonary resuscitation
• ISSN: 0733-8627; 1558-0539
• DOI: 10.1016/j.emc.2019.04.002

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.