Jones J, Dougherty J, Cannon L, Schelble D
Ann Emerg Med. 1986 Nov;15(11):1275-81. doi: 10.1016/s0196-0644(86)80608-4.
The growing number of elderly in the United States will continue to increase the demand for emergency services. Although the emergency medicine core curriculum, as defined by the American College of Emergency Physicians, requires mandatory training in pediatrics, there is no mention of geriatric care. A special body of knowledge regarding normal aging as well as the special presentation of disease in the elderly is required to provide optimum care for the aged patient. We present an integrated geriatric curriculum designed to operate within a three-year emergency medicine residency program. This curriculum identifies specific educational objectives for training in geriatric emergencies that can be summarized as follows: identify those impairments and functional disorders that often complicate diagnosis and therapy; acquire an understanding of how physiologic changes in aging affect normal laboratory and radiologic values; develop knowledge of drug side effects and interactions in this population; understand and treat the group of disease peculiar to the elderly; recognize diseases and injuries that present a different clinical picture in old age; and differentiate and treat common psychosocial emergencies in the elderly. These educational objectives are further defined using a specific interlinked framework of didactic presentations, journal clubs, case conferences, therapeutic audits, formal rotations, and consultants. This format will provide valuable educational experiences for the emergency medicine resident and may strengthen positive attitudes toward geriatric medicine.
美国老年人口数量的不断增加将持续推高对急诊服务的需求。尽管美国急诊医师学会定义的急诊医学核心课程要求进行儿科方面的强制培训,但却未提及老年护理。为老年患者提供最佳护理需要有关正常衰老以及老年人疾病特殊表现的专门知识体系。我们提出了一个综合性老年医学课程,旨在纳入一个为期三年的急诊医学住院医师培训项目。该课程确定了老年急诊培训的具体教育目标,可总结如下:识别那些常使诊断和治疗复杂化的损伤和功能障碍;了解衰老过程中的生理变化如何影响正常的实验室和放射学检查值;掌握该人群药物副作用及相互作用的知识;了解并治疗老年人特有的疾病群体;识别在老年期呈现不同临床表现的疾病和损伤;区分并治疗老年人常见的心理社会急诊。这些教育目标通过讲授、期刊俱乐部、病例讨论会、治疗审核、正式轮转和会诊等特定相互关联的框架进一步明确。这种形式将为急诊医学住院医师提供宝贵的教育体验,并可能强化对老年医学的积极态度。