The article emphasizes that effective resuscitation for older adults is not simply about applying algorithms but about tailoring care to physiology, context, and the person in front of us.
Older adults make up a rapidly growing share of emergency visits, yet most resuscitation protocols were developed for younger patients. This article outlines ten practical, evidence-based strategies to improve outcomes for critically ill older adults.
Key takeaways from the article include:
1. Avoid cognitive traps. Keep a broad differential and use diagnostic “forcing” strategies to prevent premature closure or anchoring.
2. Interpret vital signs in context. “Normal” blood pressure or heart rate may mask occult shock in older adults.
3. Adjust the ABCs. Modify airway, breathing, and circulation management for changes in anatomy, physiology, and pharmacodynamics that come with aging.
4. Think beyond antibiotics in sepsis. Source control, individualized fluid management, and early vasopressors are essential for frail patients with limited reserve.
5. Recognize trauma patterns. Even low-energy falls can cause serious injury.
6. Treat delirium as acute brain failure. Search for reversible causes, recognizing that delirium often signals underlying medical illness.
7. Practice goal-directed care. Align interventions with the patient’s values and documented goals, consistent with the “What Matters Most” principle of the Age-Friendly Health Systems initiative.
8. Bring your A-game. Resuscitating older adults demands the highest level of skill, vigilance, and teamwork.
You can access the article recently co-authored by Dr. Christina Shenvi in the Journal of Emergency Medicine.