Resuscitation of the geriatric patient

The elderly represent the fastest-growing segment of the population. As the country ages, the number of elderly patients who present in extremis will undoubtedly increase. Emergency physicians must be cognizant of the fact that age alone is a poor predictor of outcome in the critically ill elderly patient. Premorbid status, including previous level of functioning and pre-existing disease, is more important than chronologic age in predicting outcome, guiding assessment, and deciding on therapy. Knowledge and consideration of the geriatric ABCs includes a fundamental understanding that loss of protective airway reflexes, occult respiratory insufficiency, and clinically unrecognized shock are especially prevalent in the sickest geriatric patients. Early recognition and treatment can minimize morbidity and mortality rates in the ED.