Discusses the problems that are often seen in the elderly patients including demographics, sensory problems, changes in body systems, myocardial infarction, heart failure (CHF), pneumonia, pulmonary embolism, dementia, neuropathy, delirium, gastrointestinal bleeding, and medication use issues. Presentation is over 95 slides in length. Recommended classroom time is 8 hours and 4 hours lab time.

1. PREVIEW OF
EMT/EMR
GERIATRIC EMERGENCIES
POWERPOINT TRAINING
PRESENTATION

2. OBJECTIVES
Be able to
Explain aging
Describe assessment needs of elderly
Identify sensory problems with aging
Describe specific illnesses in seniors
Identify elder abuse

3. PATIENTS OVER 65+
Over half over 85 live alone or with spouse
Only 5% live in nursing homes
35,000,000 over 65 in US in 2000
1 in 8 of US population
Est 54,000,000 by 2020
Most take multiple medications

4. AGE
1900 vs. today
Age’s 65-74: 8 times large
Age’s 75-84: 13 times larger
Ages 85+: 24 times larger
Currently 12.6% US population

5. VISION
Decreased vision
Inability to differentiate colors
Decreased night vision
Decreased ability to see close up
Decreased depth perception

6. HEARING
Inability to hear high-
frequency sounds
Use of hearing aids

7. NERVOUS SYSTEM
6 to 7% brain weight decrease
45% brain cell loss in some areas
15 to 20% blood flow reduction
15% conduction speed decrease

8. CARDIOVASCULAR CHANGES
IN THE ELDERLY
Degeneration of valves
Degeneration of conduction system
Vascular changes
Muscular changes
Stroke volume
Cardiac output
Dysrhythmias

9. ASSESSMENT TOOLS
Often has previous cardiac history
Cardiac medications
Nitroglycerin
Symptoms exceeding 10-15 minutes
Pulse oximetry

10. PNEUMONIA
An infection of the lung
from bacterial, viral,
or fungal causes

12. PULMONARY EMBOLISM
A sudden blockage of the pulmonary artery by a
venous clot

13. ASSOCIATED SIGNS & SYMPTOMS
Sudden onset of dyspnea
Shoulder/back/chest pain
Syncope
Anxiety/apprehension
Fever
Leg pain/redness/unilateral pedal edema
Fatigue
Cardiac arrest

14. POSSIBLE CHANGES IN
PHYSICAL ASESSMENT
Changes in circulation
Tachycardia
Adventitious noises such as wheezing, rales or
decrease breath sounds
Decreased pulse oximetry reading of 70 percent
or lower
Hypotension

15. NEUROVASCULAR CHANGES
IN THE ELDERLY
Atrophy of the brain tissue
Deterioration of the nervous system
Neuropathy

16. DETORIATION OF THE NERVOUS
SYSTEM FUNCTION IN CONTROLLING
Rate and depth of breathing
Heart rate
Blood pressure
Hunger and thirst
Temperature
Sensory perception – including audio, visual,
olfactory, touch, and pain

17. NEUROPATHY
Damage to nerves which may impair sensation,
movement, gland or organ function or other
aspects of health, depending upon nerve
affected

18. SENSORY NEUROTHAPY
Signs & Symptoms
Numbness in touch & vibration
Reduced position sense
Poor coordination & balance
Reduced sensitivity to temperature change &
pain
Spontaneous tingling or burning pain

19. DEMENTIA
A chronic, generally irreversible condition that
causes a progressive loss of cognitive abilities,
psychomotor skills, & social skills
Alzheimer’s disease is a form of dementia

20. DEMOGRAPHICS
World wide about 36,000,000 with Dementia
10% of people develop it sometime in their life
Due to increased life expediency it is becoming a
more prevalent disease
One of the most common causes of disability in
the elderly

21. GASTROINTESTINAL
SYSTEM
Anatomical & Physiological
changes, &
pathophysiology

22. GASTROINTESTINAL (GI) CHANGES
IN THE ELDERLY
Dental problems
Decrease in saliva
Poor muscle tone of smooth muscle sphincter
between esophagus and stomach can cause
regurgitation leading to heartburn, and acid
reflux
Decrease in hydrochloric acid in the stomach
Alterations in absorption of nutrients

23. GASTROINTESTINAL (GI) CHANGES
IN THE ELDERLY
Slowing peristalsis causing constipation
Rectal sphincter may become weak resulting in
fecal incontinence
Liver shrinks
Blood flow to the liver declines
Decrease metabolism in the liver

24. ENDOCRINE CHANGES IN THE ELDERLY
Decreased metabolism of thyroxine
Decreased conversion of thyroxine to triiodothyronine
Reduction in pancreatic beta cell secretion causing
hyperglycemia
Reduction of the hormones secreted by the
hypothalamus and pituitary gland
Increase in secretion of antidiuretic hormone and
atrial natriuretic hormone causing fluid imbalance
Increase in levels of norepinephrine

25. MUSCULOSKELETAL CHANGES
IN THE ELDERLY
Atrophy of muscles and muscle wasting
Degenerative changes and loss of bone
Loss of strength
Degenerative changes in joints
Loss of elasticity in ligaments and tendons
Thinning of cartilage and thickening of synovial fluid
Osteoporosis is a bone disease that decreases bone
density

26. POLYPHARMACY
The use of multiple medications, often
prescribed by different doctors that can cause
adverse reactions in the patient

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