Geriatric EM Video Series

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From Sigh to Smile.

Older adults are increasing in number in our Emergency Department (ED). Their needs are complex and difficult to meet without the proper setting and training. This is why many of us will sigh when we see “89 F presenting with general weakness”. This course will resolve many of your questions, and give you clinical tips and tools to change your approach to the geriatric patient in the ED. Our main objective is that each participant will become a better equipped clinician and a positive leader for a population that once took care of all of us. It is our turn to give them back what they deserve: the best care.

The Geriatric EM video program provides you with 10 video modules to watch at your leisure.

Presented By:

Audrey-Anne Brousseau, MD
Audrey-Anne Brousseau, MD, MSc, FRCPC

Audrey-Anne Brousseau completed her training in emergency medicine at Université Laval and works as an emergency physician at the Centre Hospitalier Universitaire de Sherbrooke, in Quebec. She completed a fellowship in Geriatric Emergency Medicine at Mount Sinai Hospital, in Toronto, where she saw the light.

Audrey holds a masters degree in Clinical Epidemiology and a Clinical Teaching Certificate. Her interest, and best efforts, are focussed in the area of improving care for older adults in the emergency department at any level: education, ED management, research, and with an interdisciplinary approach.

Audrey’s mantra: Geriatric Emergency Medicine is teamwork!

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Atypical Presentations

Atypical presentation is typical in one third of ED presentation for older adults. Many non-specific symptoms can be the signs of an acute and severe disease in older adults.


One third of 65 years and older adults will fall each year. Drop the terms accidental or mechanical falls and use instead “multifactorial falls”.

Hip Fractures

Hip fractures are very morbid for older adults, reaching 50% of functional decline at one-year post event.

One of the main tasks of emergency physicians is pain control, and femoral block is an excellent option, safe and effective.


Understanding and screening for delirium using the “Confusion Assessment Method” in the ED is crucial to limit adverse events. It is possible to discharge older adults with delirium if you know the cause, prescribe the right treatment and the quality of environment.

Palliative Care

The definition of palliative care: Management and relief of symptoms that interfere with quality of life of patient and families who face life-threatening illness. Older patients who will likely benefit from a palliative care team are those who suffer with a significant functional decline and repeated visit to the ED.

Physiological changes

Understanding physiological changes of aging is crucial for a good clinical evaluation of older adults. Physiological reserve is globally decreased in older adults increasing their vulnerability to acute stress.

Geriatric Trauma

Age is an independent factor for adverse outcomes in trauma. Pre-hospital triage is challenging in geriatric trauma. Some indicators exist but there is still under triage in the field.


Frailty in older adults is an overarching concept and must be taken into account when caring older adults; frailty is definitely a better indicator of health the age alone. The theoretical definition of frailty is clear, but how to operationalize it clinically is challenging. Many tests and scores co-exist and they all have limitations.


Geriatric emergency medicine is teamwork and an interdisplinary team is mandatory in order to optimize older adults care in the ED. The Geriatric Emergency Department Guidelines gather evidence based and meaningful project ideas to improve care in the ED.


About one third of older adults ED visits are related to medications (e.g.: adverse events, interactions, non-compliance). Before adding or stopping any medication for older adults, consider physiological changes of aging, interaction potential, risks/benefits balance and guidelines.


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