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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

170
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

143
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
143
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
193
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

198
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
198
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

156
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
156
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

142
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
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Too old for a paediatric emergency department? It's complex.

Michael Bennett1, Claudio Dalla Vecchia1, Carol Blackburn1,2

  • 1Department of Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland.

Irish Journal of Medical Science
|March 18, 2020
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Summary

Older adolescents and adults over 15 years accessing pediatric emergency departments (PEDs) often have complex medical conditions. This study highlights their significant presence and need for specialized services within these settings.

Keywords:
Chronic complex conditionsEmergency servicesPaediatric emergency medicine

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Area of Science:

  • Pediatric Emergency Medicine
  • Adolescent Healthcare
  • Complex Chronic Conditions

Background:

  • Paediatric emergency departments (PEDs) in Ireland primarily serve individuals under 16.
  • The characteristics of patients aged 16 and older presenting to PEDs are not well-described.
  • Understanding this demographic is crucial for optimizing emergency care services.

Purpose of the Study:

  • To describe the patient profiles of individuals over 15 years old presenting to a national tertiary pediatric emergency department.
  • To analyze their reasons for attendance, diagnoses, and outcomes.

Main Methods:

  • Retrospective review of electronic health records for patients aged 16-61 presenting between January 2014 and December 2015.
  • Data collected included demographics, chief complaints, diagnoses, treatments, and disposition.
  • Analysis focused on identifying patterns in presentations and patient complexity.

Main Results:

  • 426 patients (0.6%) aged 16-61 attended the PED.
  • Over half had complex chronic conditions (CCC).
  • 89% were known to pediatric services; 11% presented with de novo issues (minor injuries, syncope, chest pain most common).

Conclusions:

  • A significant population over 15 with medical complexity utilizes PEDs in Ireland.
  • These patients require specialized services accessed via unscheduled emergency care.
  • Further research is recommended to characterize pediatric CCC in Irish emergency and hospital services.