Geriatric patients are defined as individuals aged 65 years and older. Geriatric patients have a higher likelihood of hiding potentially life-threatening conditions due to age-related physiological changes, comorbidities, and multiple medications.
Avoid scheduled use of NSAIDs like ibuprofen in older adults. Elderly patients may be on multiple medications, which can increase the risk of drug interactions and adverse effects. Adding NSAIDs can lead to significant renal dysfunction, including renal failure. Acetaminophen is a safer alternative for pain control in elderly patients.
Sgarbossa criteria are used to identify myocardial infarction in the presence of a left bundle branch block (LBBB) or a ventricular paced rhythm. Collaboration with cardiologists is essential to consider this possibility.
Geriatric patients often present with diffuse and nonspecific abdominal pain due to compromised visceral sensation. It is reasonable to make CT the default test for abdominal pain in elderly patients.
Delirium can have life-threatening causes such as SDH, sepsis, electrolyte imbalance, or drug intoxications. Identifying and treatment of the reversible causes of delirium are essential to prevent morbidity and mortality.
Non-situational syncope in the elderly requires work-up. Listen for new murmur, obtain a 12-lead ECG, and consider echocardiogram and 24-hour Holter ECG.
Elderly patients may not exhibit typical signs of sepsis, such as fever. Instead, they may present with subtle symptoms such as confusion, lethargy, or generalized weakness.
Geriatric trauma patients are frequently under-triaged, resulting in increased mortality rates. Geriatric blunt trauma patients warrant increased vigilance despite normal vital signs on presentation. Trauma triage set points of HR above 90 or SBP below 110 mm Hg should be considered in the geriatric blunt trauma patients.
Occult hip fractures not visible on plain radiography need further imaging. While CT scans are helpful, MRI remains the gold standard for diagnosis of occult hip fractures, including stress fractures and avulsion fractures.
Evaluating the walking ability of older adults post-fall is crucial before discharge. Providing appropriate walking aids, such as walkers or canes, reduces the risk of further falls and potential injuries. Implementing falls prevention strategies, such as home modifications and exercise programs, further reduces the risk of falls and associated morbidity and mortality.
Elder abuse is unfortunately not uncommon. Look for signs of physical abuse, such as unexplained bruises, burns, or scars, and injuries to the left side of the face or ears. Genital injuries or sexually transmitted infections also raise suspicion for elder abuse.