Palliative care in the ED

Palliative care in the ED. Two things that does not seem to be related and even counter-intuitive! In the ED, we save lives right?! Right! But not at all price. I did a presentation with a palliative care physician, Dr Russell Goldman from the Tammy Latner Center for Palliative Care about this topic and he taught …

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Physiologic change of aging

Older adults are not adults with grey hair. It is the same principle for pediatrics, they have their own physiologic particularities. These differences are very important to understand because it will change the clinical management. Lets review what happens when the body ages, starting at 25 years old! (Oh yes!) But first, I would like …

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Grandma stopped eating…

During my geri-psych rotation, a surprising common reason for referral was: not wanting to eat, please evaluate. Really? Geri-psych? Is that really a thing? Sometimes, it is the chief complaint in the emergency department. And most of emergency physicians would probably pause and ask "What do I know about this?", and answer, "nope, nothing". I discovered …

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Hip fracture Co-Management

Hip fractures in our older adults population are common and carry a significant increase in mortality and morbidity. Some sources stated 60% mortality at 6 months and many who survived will not recover their baseline independence. It is deadly. Here, they have an interesting way to manage their hip fracture population based on a few …

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Urinary Tract Infections and Elderly

When I first started my medical education, I was told to always test for UTI in older adults with falls, delirium or any other vague complaints. I ended up treating a lot of positive urinanalysis. Then, the phenomenon of antibiotic resistance emerged and the rationalisation of antibiotic use was becoming the new standard of practice. …

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