Geriatric Emergency Medicine

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ME 3.22.1.1

Physiological changes of ageing.

ME 3.22.1.2

Changes in pharmacokinetics and pharmacodynamics in older patients.

ME 3.22.1.3

Polypharmacy and adverse reactions, including drug-drug and drug- disease interactions.

ME 3.22.1.4(a)

Geriatric syndromes and their relevance to emergency management of older persons including: Frailty

ME 3.22.1.4(b)

Geriatric syndromes and their relevance to emergency management of older persons including: Delirium (including subtypes)

ME 3.22.1.4(c)

Geriatric syndromes and their relevance to emergency management of older persons including: Falls

ME 3.22.1.4(d)

Geriatric syndromes and their relevance to emergency management of older persons including: Pressure injury

ME 3.22.1.4(e)

Geriatric syndromes and their relevance to emergency management of older persons including: Incontinence

ME 3.22.1.5(a)

Increased prevalence of cognitive and sensory impairments in older patients and their impact on; Increased risk of accidental injury

ME 3.22.1.5(b)

Increased prevalence of cognitive and sensory impairments in older patients and their impact on; Increased risk of accidental overdose

ME 3.22.1.5(c)

Increased prevalence of cognitive and sensory impairments in older patients and their impact on; Assessment and management in the ED

ME 3.22.1.6

Elicit a history from older persons, their family/whānau and carers.

ME 3.22.1.7

Perform a medication review, especially for older persons presenting with falls or with polypharmacy.

ME 3.22.1.8

Identification and progression of pathology in common presentations of older people.

ME 3.22.1.9

Pain assessment and management in older persons and in those with cognitive impairment.

ME 3.22.1.10

Modifications to emergent interventions for older patients based on anatomical or physiological changes, risk assessment and goals of care.

ME 3.22.1.11

Trauma management in older persons, including the increased risk of potentially avoidable complications.

ME 3.22.1.12

Assessment and management (non-pharmacological and pharmacological) of behavioural disturbance in older patients.

ME 3.22.1.13(a)

Identification, management and prevention of iatrogenic injuries and their complications, including those associated with: Bladder catheterisation,

ME 3.22.1.13(b)

Identification, management and prevention of iatrogenic injuries and their complications, including those associated with: Spinal immobilisation,

ME 3.22.1.13(c)

Identification, management and prevention of iatrogenic injuries and their complications, including those associated with: Invasive line placement

ME 3.22.1.13(d)

Identification, management and prevention of iatrogenic injuries and their complications, including those associated with: Skin tears and pressure injuries

ME 3.22.1.14

Altered laboratory findings and interpretation of investigations in older patients.

ME 3.22.1.15(a)

Common presentation patterns in older patients, including: Delirium

ME 3.22.1.15(b)

Common presentation patterns in older patients, including: Abdominal pain

ME 3.22.1.15(c)

Common presentation patterns in older patients, including: Falls or collapse

ME 3.22.1.15(d)

Common presentation patterns in older patients, including: Sepsis and common causes of infection

ME 3.22.1.15(e)

Common presentation patterns in older patients, including: Chronic wounds

ME 3.22.2.1

Risks of under-triage in older patients.

ME 3.22.2.2

Discharge risk assessment and multidisciplinary team assessment in older persons.

ME 3.22.2.3

Optimising transitions of care including specific discharge needs of older persons living in residential aged care.

ME 3.22.2.4

Signs and injury patterns that suggest elder abuse.

ME 3.22.2.5(a)

Law and ethics in the care of older persons, including: Advance care directives and hierarchy of substitute decision makers

ME 3.22.2.5(b)

Law and ethics in the care of older persons, including: Defining goals of care

ME 3.22.2.5(c)

Law and ethics in the care of older persons, including: Involvement of the coroner

ME 3.22.2.6

Atypical and subtle presentations of disease in older persons and the increased risk of diagnostic error.

ME 3.22.2.7(a)

Assess and manage common geriatric emergencies and presentations, including: Geriatric trauma, including falls and hip fracture

ME 3.22.2.7(b)

Assess and manage common geriatric emergencies and presentations, including: Weakness, immobility,

ME 3.22.2.7(c)

Assess and manage common geriatric emergencies and presentations, including: Dizziness, balance and gait disorders

ME 3.22.2.7(d)

Assess and manage common geriatric emergencies and presentations, including: Cognitive, behavioural and psychological/mood disorders, including dementia, delirium, depression and anxiety

ME 3.22.2.7(e)

Assess and manage common geriatric emergencies and presentations, including: Side effects from polypharmacy use

ME 3.22.2.7(f)

Assess and manage common geriatric emergencies and presentations, including: Toxicological presentations, including acute and chronic, intentional and accidental

ME 3.22.2.7(g)

Assess and manage common geriatric emergencies and presentations, including: Skin care / chronic wounds

ME 3.22.2.8

Provide end of life care for the older patient in the ED.

ME 3.22.2.9

Co-ordinate a functional assessment in the older patient, including mobility assessment, Activities of Daily Living (ADLs) and Instrumental ADLs, and incorporate findings into the management plan.

ME 3.22.2.10

Generate a differential diagnosis for an older patient's presentation.

ME 3.22.2.11

Screen for comorbid conditions and potential complications of current treatment.

ME 3.22.2.12

Screen the home environment details, including availability, capability and stress of formal and informal caregivers.

ME 3.22.2.13

Co-ordinate the care of older patients, involving multiple different agencies as required.

ME 3.22.3.1

Safely perform procedures in older patients, with recognition and treatment of iatrogenic injuries and complications when they occur.

ME 3.22.3.2

Manage incidents of abuse and neglect, in accordance with institutional and state guidelines.

ME 3.22.3.3

Recruit an increased variety of agencies when managing older patients with concurrent medical and mood disorders.