McNamara R M, Rousseau E, Sanders A B
Department of Emergency Medicine, Medical College of Pennsylvania, Philadelphia.
Ann Emerg Med. 1992 Jul;21(7):796-801. doi: 10.1016/s0196-0644(05)81024-8.
To evaluate the current status of clinical, educational, social, ethical, and resource issues related to the care of the elderly among practitioners of emergency medicine.
A mailed survey instrument.
None.
Practicing emergency physicians randomly drawn from the membership list of the American College of Emergency Physicians.
None.
A total of 971 surveys were mailed, with 433 usable surveys among the 485 (50%) respondents. The surveyed emergency physicians anticipated a major impact on emergency department patient flow and bed availability in the hospital and ICU as the population ages. For each of seven clinical presentations (abdominal pain, altered mental status, chest pain, dizziness/vertigo, fever without a source, headache, multisystem trauma), 45% or more of the emergency physicians have more difficulty in the management of older compared with younger patients. Most respondents reported that each of these presentations required more time and resources for older patients. The majority believed research, the availability of continuing medical education, and time spent during residency training regarding geriatric emergency medicine was inadequate.
Practicing emergency physicians are uncomfortable with elderly patients, and this may reflect the inadequacies of training, research, and continuing education in geriatric emergency medicine.
评估急诊医学从业者在照顾老年人方面临床、教育、社会、伦理和资源问题的现状。
邮寄调查问卷。
无。
从美国急诊医师学会会员名单中随机抽取的执业急诊医师。
无。
共邮寄971份调查问卷，485名（50%）受访者中有433份可用调查问卷。受访的急诊医师预计，随着人口老龄化，这将对急诊科患者流量以及医院和重症监护病房的床位供应产生重大影响。对于七种临床表现（腹痛、意识改变、胸痛、头晕/眩晕、不明原因发热、头痛、多系统创伤）中的每一种，45%或更多的急诊医师表示，与年轻患者相比，管理老年患者更困难。大多数受访者表示，这些临床表现中的每一种都需要为老年患者投入更多时间和资源。大多数人认为，关于老年急诊医学的研究、继续医学教育的可获得性以及住院医师培训期间花费的时间都不足。
执业急诊医师对老年患者感到棘手，这可能反映出老年急诊医学在培训、研究和继续教育方面的不足。
