Sanders A B
Department of Surgery, University of Arizona College of Medicine, Tucson.
Ann Emerg Med. 1992 Jul;21(7):830-4. doi: 10.1016/s0196-0644(05)81030-3.
Little attention is being paid to the special needs of elderly persons in emergency departments. Emergency health care professionals feel less comfortable caring for elderly than for nonelderly patients. The social and personal concerns of the elderly frequently are not addressed in ED encounters. There is a paucity of research and education in geriatric emergency medicine. Overall principles of care for elderly patients seeking emergency care have not been defined as they have for other special populations such as children. The disease-oriented model used for caring for nonelderly adult patients in EDs may not be appropriate for elderly patients. The emergency care of the elderly requires significantly more health care resources than does that of the nonelderly. Compared with nonelderly patients, elderly patients seeking emergency care are four times more likely to use ambulance services, five times more likely to be admitted to the hospital, five times more likely to be admitted to an intensive care bed, and six times more likely to receive comprehensive emergency services. Although 12% of the population is 65 years or older, this group accounted for 36% of all ambulance patient transports to EDs, 43% of all hospital ED admissions, and 48% of all critical care admissions from EDs. These problems are particularly important at this time because many hospitals and their EDs are faced with significant problems of overcrowding and inadequate resources to meet the health care needs of the communities they serve. Although the elderly are the fastest-growing segment of the population, little or no planning is ongoing to meet the emergency health care needs of the elderly in the future. The task force has provided specific recommendations for addressing these problems.
急诊科对老年人的特殊需求关注甚少。与照顾非老年患者相比，急诊医护人员在照顾老年人时感觉不那么自在。老年人的社会和个人问题在急诊就诊时常常得不到解决。老年急诊医学领域的研究和教育匮乏。与儿童等其他特殊人群不同，针对寻求急诊治疗的老年患者的总体护理原则尚未明确。用于急诊科非老年成年患者护理的以疾病为导向的模式可能不适用于老年患者。老年人的急诊护理比非老年人需要更多的医疗资源。与非老年患者相比，寻求急诊护理的老年患者使用救护车服务的可能性高四倍，住院的可能性高五倍，入住重症监护病床的可能性高五倍，接受全面急诊服务的可能性高六倍。尽管12%的人口年龄在65岁及以上，但该群体占所有通过救护车送往急诊科患者的36%，占所有医院急诊科入院患者的43%，占所有从急诊科转入重症监护病房患者的48%。目前这些问题尤为重要，因为许多医院及其急诊科面临着严重的拥挤问题和资源不足的问题，无法满足其所服务社区的医疗需求。尽管老年人是人口中增长最快的群体，但目前几乎没有或根本没有针对未来满足老年人急诊医疗需求的规划。特别工作组已针对解决这些问题提出了具体建议。
