EM SAQs · Geriatric emergency medicine
Elderly and frailty in ED — SAQ
An ACEM-style SAQ on the systematic ED assessment of the older adult with a fall.
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Prompt
An 84-year-old woman is brought in after a fall at home. She lives alone, uses a walker, and is on eight chronic medications. Observe and describe your systematic ED assessment.
Stem
An 84-year-old woman is brought in by ambulance after a fall at home. She lives alone, uses a walker, and is on eight chronic medications.
a) Outline your systematic ED assessment including the bedside bundle — postural BP, gait and mobility, medications, cognition. [2]
b) Score her Clinical Frailty and justify the score. [3]
c) State the disposition plan, including osteoporosis linkage and allied health. [2][4]
References5ShowHide
- [1]Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people CMAJ, 2005.PMID 16129869
- [2]Smyth H, Breslin D, Mullany L, et al. Silver Trauma Review Clinic: a novel model of care to manage non-operative injuries in older patients. Emerg Med J, 2023.PMID 37640437
- [3]Church S, Rogers E, et al. A scoping review of the Clinical Frailty Scale. BMC Geriatr, 2020.PMID 33028215
- [4]Nakayama A, Major G, et al. Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int, 2016.PMID 26650377
- [5]Fried LP, Tangen CM, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001.PMID 11253156