Frail older people now contribute the majority of the acute emergency take both medical and surgical. Despite this there is often a lack of confidence and knowledge among doctors and nurses in treating older people in the Emergency Department and on Emergency Assessment Units.From the Preface
Emergency care of frail older people is challenging but very rewarding. Older patients tend to be complex and therefore their assessment needs to be more extensive and include comprehensive geriatric assessment. It is the extras in their assessment that are not usually needed in younger patients, such as cognitive, functional and social evaluations that make the difference in achieving a better outcome.
This book describes the key features of high quality care for frail elderly patients in acute hospital settings. With chapters on assessment and the characteristic non-specific ways that patients tend to present (such as 'confusion', 'collapse query cause' and 'off legs'), this practical guide is ideal to have on-hand. As well as common medical and surgical conditions, it also covers medication management, elder abuse, pressure ulcers and hypothermia, including the physiological changes seen in ageing and ways to define frail patients.
Tables, diagrams and images are ideal for quick reference, and key points are summarised throughout the text to aid comprehension, providing doctors, nurses and therapists with both background and essential information to provide the excellent acute care older people deserve.
Author(s): Henry Woodford, James George
Publisher: CRC Press
Year: 2013
Language: English
Pages: 343
City: Boca Raton
Cover
Title Page
Copyright Page
Table of Contents
Foreword
Preface
About the Authors
List of Abbreviations
1: Introduction
What is Old Age?
Changes in Physiology
Frailty
Older People in Acute Hospitals
Reasons for Attending Hospital
Outcomes
Intensive Therapy Unit and High Dependency Unit Care
Resuscitation
Hazards of Hospitalisation
Rehabilitation
Discharge Planning
Readmissions
Alternatives to Acute Hospitals
Care Homes
2: Assessment
Initial Rapid Assessment
Comprehensive Geriatric Assessment
History
Physical Examination
Functional Assessment
Cognitive Assessment
Mood Assessment
Nutritional Assessment
Investigations
3: ‘Off Legs’: Non-Specific Functional Decline
Atypical Presentations of Disease
Malnutrition
Dehydration
Acute Kidney Injury
Rhabdomyolysis
Electrolyte Disturbances
Constipation
Incontinence
Pressure Ulcers
Accidental Hypothermia
4: Confusion
Delirium, Dementia or Both?
Delirium
Dementia
5: ‘Collapse Query Cause’: Falls and Blackouts
Falls
Blackouts
Syncope
Epilepsy
6: Surgical Care
Perioperative Care
Abdominal Pain
Trauma
7: Infection
Prognostic Markers
Bacteraemia
Sepsis
Antibiotics
Pneumonia
Influenza
Urinary Tract Infection
Clostridium Difficile Infection
Methicillin-Resistant Staphylococcus Aureus
Infective Endocarditis
Meningitis
Encephalitis
Skin and Soft Tissue Infections
8: Cerebrovascular Disease
Stroke
Transient Ischaemic Attack
Ischaemic Stroke and Transient Ischaemic Attack
Intracerebral Haemorrhage
9: Chest Pain and Shortness of Breath
Acute Coronary Syndromes
Heart Failure
Cardiac Arrhythmias
Aortic Dissection
Pulmonary Embolism
Chronic Obstructive Pulmonary Disease
10: Other Presentations
Dizziness
Acute Gastrointestinal Haemorrhage
Parkinson’s Disease
Depression
Diabetes
Headache
Acute Back Pain
Acute Joint Inflammation
Elder Abuse
Palliative Care
11: Medications
Changes in Pharmacokinetics
Changes in Pharmacodynamics
Evidence-Based Medicine
Polypharmacy
Prescribing for Older People
Goals of Therapy
Adverse Drug Reactions
Inappropriate Medications
Concordance and Adherence
Medication Review
Index
