81-84 of 84 results with category "Geriatrics"
Be wary of the limitations of correlating a temperature with infection in the elderly:
1. The elderly are 3-4x more likely to develop hypothermia in response to serious infections. Never rule out a serious infection simply based on a low or normal body temperature.
2. The elderly take longer to mount a fever than younger patients.
3. The elderly have a slightly lower body temperature at baseline, possibly 1 degree lower. As a result, "fever" in the elderly is sometimes defined as 99.5 degrees rather than the traditional 100 or 100.4 used in younger patients.
Hypovolemia is very common in the ederly for two reasons:
1. The elderly have a decreased thirst response...in other words, it takes longer for them to develop thirst in the setting of dehydration.
2. The elderly have a decreased renal vasopressin response to hypovolemia.
From a treatment standpoint, one should always assume an elderly patient is hypovolemic. Hydration is incredibly important during resuscitation of the elderly patient.
The elderly are at tremendous risk of death after MI, in no small part because we tend to undertreat them. The 30-day mortality rate after MI in patients < 65 is 3%.
In patients 65-74, the 30-day mortality is 10%.
In patients 75-84, the 30-day mortality is 20%.
In patients > 85, the 30-day mortality is 30%.
Be vigilant and be aggressive with elderly patients. Their early management has a tremendous bearing on their later outcomes.
Whereas only 6% of young patients with PE present with syncope, 15-20% of elderly patients with PE present with syncope. The simple takeaway point is that whenever an elderly patient presents with syncope, always strongly consider the possibility of PE, even though they may lack classic pleuritic chest pain.
Count that respiratory rate for an inexpensive clue!