Download PDF
Innere Medizin up2date 2014; 2(04): 271-283
DOI: 10.1055/s-0034-1387480
Innere Medizin im Alter
© Georg Thieme Verlag KG Stuttgart · New York

Geriatrische Notfälle

Karen Delport
,
Christian H. Nickel
Further Information

Publication History

Publication Date:
09 December 2014 (online)

Also available at
   Buy Article Permissions and Reprints All articles of this category

See also:

Geriatrische NotfälleNOTARZT 2012; 28(04): 171-180
DOI: 10.1055/s-0032-1305168

Einleitung: Besonderheiten des älteren Notfallpatienten

Ältere Patienten (≥ 65 Jahre) stellen spezielle Herausforderungen für Notfallmediziner dar. Im Vergleich zu jüngeren Patienten stellen sich ältere Patienten, hierbei insbesondere die sehr alten (≥ 85 Jahre), häufiger auf Notfallstationen vor, kommen häufiger mit dem Rettungsdienst, nehmen mehr Zeit und Ressourcen auf der Notfallstation in Anspruch, werden häufiger hospitalisiert und verzeichnen längere Spitalaufenthalte. Auch das Risiko, erneut auf einer Notfallstation vorstellig zu werden, ist erhöht.

 

  • Literatur

  • 1 Aminzadeh F, Dalziel WB. Older adults in the emergency department: A systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002; 39: 238-247
    CrossrefGoogle Scholar
  • 2 Downing A, Wilson R. Older people’s use of Accident and Emergency services. Age Ageing 2005; 34: 24-30
    CrossrefGoogle Scholar
  • 3 Sklar DP et al. Unanticipated death after discharge home from the emergency department. Ann Emerg Med 2007; 49: 735-745
    CrossrefGoogle Scholar
  • 4 Salvi F et al. The elderly in the emergency department: a critical review of problems and solutions. Intern Emerg Med 2007; 2: 292-301
    CrossrefGoogle Scholar
  • 5 Bundesamt. D.s. Bevölkerungspyramide. Available from: 2009. https://www.destatis.de/bevoelkerungspyramide (letzter Zugriff: 17.11.2014)
    Google Scholar
  • 6 Battistella FD, Din AM, Perez L. Trauma patients 75 years and older: long-term follow-up results justify aggressive management. J Trauma 1998; 44: 618-623; discussion 623
    CrossrefGoogle Scholar
  • 7 Nickel CH, Nemec M, Bingisser R. Weakness as presenting symptom in the emergency department. Swiss Med Wkly 2009; 139: 271-272
    PubMedGoogle Scholar
  • 8 Nemec M et al. Patients presenting to the emergency department with non-specific complaints: the Basel Non-specific Complaints (BANC) study. Acad Emerg Med 2010; 17: 284
    CrossrefPubMedGoogle Scholar
  • 9 Chang DC et al. Undertriage of elderly trauma patients to state-designated trauma centers. Arch Surg 2008; 143: 776-781; discussion 782
    CrossrefGoogle Scholar
  • 10 Grossmann FF et al. At Risk of Undertriage? Testing the Performance and Accuracy of the Emergency Severity Index in Older Emergency Department Patients. Ann Emerg Med 2012; 60: 317-325
    CrossrefGoogle Scholar
  • 11 Spaniolas K, Cheng JD et al. Ground level falls are associated with significant mortality in elderly patients. J Trauma 2010; 69: 821-825
    CrossrefGoogle Scholar
  • 12 Bergeron E et al. A simple fall in the elderly: not so simple. J Trauma 2006; 60: 268-273
    CrossrefGoogle Scholar
  • 13 Fuller GF. Falls in the elderly. Am Fam Physician 2000; 61: 2159-2168, 2173 – 2174
    Google Scholar
  • 14 Han JH, Wilber ST. Altered mental status in older patients in the emergency department. Clin Geriatr Med 2013; 29: 101-136
    CrossrefPubMedGoogle Scholar
  • 15 Han JH, Wilson A, Ely EW. Delirium in the older emergency department patient: a quiet epidemic. Emerg Med Clin North Am 2010; 28: 611-631
    CrossrefGoogle Scholar
  • 16 Grossmann FF, Hasemann W, Graber A et al. Screening, detection and management of delirium in the emergency department – a pilot study on the feasibility of a new algorithm for use in older emergency department patients: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). Scand J Trauma Resusc Emerg Med 2014; 22: 19
    CrossrefPubMedGoogle Scholar
  • 17 Morris JA, MacKenzie EJ, Edelstein SL. The Effect of Preexisting Conditions on Mortality in Trauma Patients. JAMA: The Journal of the American Medical Association 1990; 263: 1942-1946
    CrossrefGoogle Scholar
  • 18 Hohl CM et al. Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med 2001; 38: 666-671
    CrossrefGoogle Scholar
  • 19 Hohl CM, Zed PJ et al. Do emergency physicians attribute drug-related emergency department visits to medication-related problems?. Ann Emerg Med 2010; 55: 493-502
    CrossrefGoogle Scholar
  • 20 O’Mahony D, O’Sullivan D, Byrne S et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing 2014; Oct 16. pii: [Epub ahead of print]
    Google Scholar
  • 21 Ryan C, O’Mahony D, Kennedy J et al. Potentially inappropriate prescribing in older residents in Irish nursing homes. Age Ageing 2013; 42: 116-120
    CrossrefGoogle Scholar
  • 22 Budnitz DS et al. Medication use leading to emergency department visits for adverse drug events in older adults. Ann Intern Med 2007; 147: 755-765
    CrossrefGoogle Scholar
  • 23 O’Connell H, Ai-Vyrn C et al. Alcohol use disorders in elderly people – redefining an age old problem in old age. BMJ 2003; 327: 664-667
    CrossrefGoogle Scholar
  • 24 Wu LT, Blazer DG. Illicit and nonmedical drug use among older adults: a review. J Aging Health 2011; 23: 481-504
    CrossrefGoogle Scholar
  • 25 Norman DC, Yoshikawa TT. Fever in the elderly. Infect Dis Clin North Am 1996; 10: 93-99
    CrossrefGoogle Scholar
  • 26 Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am 2006; 24: 371-388
    CrossrefGoogle Scholar
  • 27 Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clin Interv Aging 2006; 1: 253-260
    CrossrefGoogle Scholar
  • 28 Howlett SE. CHAPTER 14 – Effects of Aging on the Cardiovascular System, in Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. (SEVENTH EDITION). Philadelphia: W. B. Saunders; 2010: 91-96
    CrossrefGoogle Scholar
  • 29 Kratz CD et al. Pharmakologische Besonderheiten und Probleme des älteren Patienten. Der Anaesthesist 2005; 54: 467-475
    CrossrefGoogle Scholar
  • 30 Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol 2008; 28: 370-372
    CrossrefPubMedGoogle Scholar
  • 31 Imperato J, Sanchez LD. Pulmonary emergencies in the elderly. Emerg Med Clin North Am 2006; 24: 317-338
    CrossrefGoogle Scholar
  • 32 Bulger EM et al. Rib fractures in the elderly. J Trauma 2000; 48: 1040-1046; discussion 1046 – 1047
    CrossrefGoogle Scholar
  • 33 Bergeron E et al. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma 2003; 54: 478-485
    CrossrefGoogle Scholar
  • 34 Alexander KP, Newby LK. Acute coronary care in the elderly, part II: ST-segment-elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation 2007; 115: 2570-2589
    CrossrefGoogle Scholar
  • 35 Franko J et al. Advanced age and preinjury warfarin anticoagulation increase the risk of mortality after head trauma. J Trauma 2006; 61: 107-110
    CrossrefGoogle Scholar
  • 36 Sacco RL, Wolf PA, Bharucha NE et al. Subarachnoid and intracerebral hemorrhage: natural history, prognosis, and precursive factors in the Framingham Study. Neurology 1984; 34: 847-854
    CrossrefGoogle Scholar
  • 37 Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med 2000; 342: 29-36
    CrossrefGoogle Scholar
  • 38 Kulchycki LK, Edlow JA. Geriatric neurologic emergencies. Emerg Med Clin North Am 2006; 24: 273-298
    CrossrefGoogle Scholar