Goal-Directed Care: 10 Tips for Resuscitating Older Adults in the Emergency Department

The resuscitation of older adults in the emergency department (ED) presents unique challenges due to physiological changes with aging, loss of physiologic reserve, polypharmacy, multimorbidity, and often unknown care goals. This review outlines ten high-yield, practical strategies to improve the care of critically ill older adults. We emphasize the importance of a patient-centered, goal-directed approach to care. The article discusses the importance of avoiding cognitive biases, interpreting vital signs in the context of aging, and adapting airway, breathing, and circulatory management techniques for the older patient. Special attention is given to recognizing and managing delirium, evaluating trauma with age-specific considerations, and tailoring diagnostic approaches and resuscitation care. These principles aim to enhance both the quality and appropriateness of emergency care for this rapidly growing and vulnerable population.