Monday, May 27, 2019 • 10:45 - 12:15
Track 3 - Geriatric EM: POCUS; Interdisciplinary Care; ACS in the Elderly
Track Chair: Dr. Don Melady

This track will help you more appropriately assess older ED patients who may have cardiac problems; will introduce you to valuable techniques for ultrasound in the older population; and will let you hear how interdisciplinary colleagues – PT, NP, SW – can add to the physician’s assessment of older ED patients.

Optimal Use of Pocus for the Geriatric ED Population - Dr. Audrey-Anne Brousseau

Description: This presentation will review best practices (indications and limitations) regarding POCUS in the older adults population.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Recognize clinical situations where POCUS can be helpful in the diagnostic investigation
  2. Integrate ultrasound-guided regional analgesia in the care of common geriatric traumatic lesion such as hip, ribs and wrist fractures.
  3. Describe the limitations of POCUS in the older adults population.

Graduated from Laval University (Quebec, Canada) in emergency medicine, I pursued a one-year fellowship in Geriatric Emergency Medicine in Toronto. With a certificate in Clinical Teaching and a Master in clinical epidemiology I am devoting my time in providing the best care care for older adults in the Emergency Department.

She Is Not Ready to Go Home Yet! Discharge Planning for the Complex Elderly Patient – Advice from Our Interprofessional Colleagues - Ms. Nikki Kelly (NP), Mr. Scott McCulloch (PT), Mr. John Calder (SW), Dr. Doug Sinclair (moderator)

Description: An interdisciplinary panel on enhanced assessment of the complex older patient, chaired by Dr. Doug Sinclair.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Identify patients at high risk for discharge from the ED.
  2. Describe the role of the IP team in the assessment of the complex elderly patient.

Nikki Kelly is a nurse practitioner in the emergency department at the Queen Elizabeth II Health Sciences Centre. Her clinical interest is with frail and vulnerable adults with the goal of utilizing interprofessional teams to provide the best ED care.

Scott McCulloch is the Manager of Seniors for the Western Zone with the Nova Scotia Health Authority. A physiotherapist by trade, has been practicing with a focus on the geriatric population for over 10 years with a primary focus on delivery of services to seniors in the emergency department as well as community. He has a passion for innovative programming to best supports seniors in maintaining their independence.

Dr. Sinclair is an emergency physician at the Nova Scotia Health Authority, and the IWK Health Centre in Halifax, and is also on staff at St. Michaels Hospital and is a full professor of Emergency Medicine at the University of Toronto. Dr Sinclair is former chief of three separate EDs, recently retired from the positions of executive vice-president and Chief Medical Officer at St. Mike’s. He is a past university department chair and a former CAEP president. And currently a proud and happy grandfather.

ACS in the Elderly: When Traditional Teaching Falls Short - Dr. Amal Mattu

Description: Elderly patients are well-known to present to the emergency department with atypical symptoms and signs for many common diseases. Delayed diagnoses and misdiagnoses are common, and the often result in disastrous consequences. There is no condition for which this is more common than for acute coronary syndromes (ACS). The speaker will discuss physiologic changes that occur with aging and the influence that these have on patient presentations of ACS. The speaker will also discuss many of the atypical presentations in the elderly and some key changes in management.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Describe physiologic changes to the cardiovascular system that occur with aging.
  2. List typical presentations for ACS in the elderly patient.
  3. List similarities and differences in the treatment regimen of elderly patients compared to younger patients.

Pearls

  1. Be liberal with fluids in the hypotensive elder patient.
  2. Use creatinine clearance when dosing medications.
  3. Chest pain is often absent in the elderly.

Dr. Mattu is a tenured Professor of Emergency Medicine and Vice Chair of Academic Affairs in the Department of Emergency Medicine at the University of Maryland School of Medicine.