Acute Emergencies and Critical Care of the Geriatric Patient by Thomas T. Yoshikawa, Dean C. Norman

By Thomas T. Yoshikawa, Dean C. Norman

This incisive reference systematically experiences the analysis and therapy of universal surgical and clinical emergencies in aged patients-thoroughly interpreting surgical interventions, drug cures and drug prescribing protocols, life-threatening drug reactions, moral concerns, and strategies of profiling sufferers for nursing care. Evaluates illness states and gauges optimum responses to every, helping thoughts with invaluable case reports. Written via over forty distinct health workers, Acute Emergencies and important Care of the Geriatric sufferer ·describes perfect patient-physician relationships in severe care settings ·highlights emergency administration of myocardial infarction and cardiogenic pulmonary edema ·illuminates moral questions surrounding confidentiality, trained consent, surrogate determination making, and sufferer convenience ·assesses specific pharmacokinetic and pharmacodynamic stipulations in geriatric sufferers ·provides very important details on stroke, seizures, and spinal twine compression ·investigates serious problems attributable to pneumonia, meningitis, and endocarditis ·explores acute lung issues akin to emphysema, power bronchitis, pneumonia, crucial apprehensive process disorder, and irregular keep watch over of air flow ·clarifies preoperative approaches for emergency surgical procedure ·reviews anesthesia ideas for pulmonary, cardiovascular, renal, hepatic, and neurological stipulations within the aged ·and extra! together with over a thousand references, tables, and illustrations, Acute Emergencies and important Care of the Geriatric sufferer is an crucial source for geriatricians, basic care physicians, internists, emergency drugs physicians, intensivists, hosptialists, surgeons, anesthesiologists, orthopedists, cardiologists, psychiatrists, neurologists, and internists/residents in those disciplines, in addition to nurses, pharmacists, and clinical scholars.

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The effect of atropine on heart rate is less marked in the elderly (15). Specific disease states may also alter pharmacodynamic effects of the drug. Sedative and analgesic drugs have been observed to have more pronounced effects in those with renal, hepatic, and respiratory insufficiency. Changes in plasma electrolytes may depress or enhance drug action; for example, a decrease in serum potassium may potentiate digoxin effects (16). Low serum potassium and magnesium will potentiate amphotericin B nephrotoxic effects.

Enabling Appropriate Transfer Critically ill patients who are evaluated in the emergency department are often admitted to the hospital, but they may also be transferred to other settings, depending on the goals of care. Transfers from the emergency department to nonhospital settings may become increasingly frequent as prospective systems of financing care involving more than one setting become more common. For example, an elderly woman who was brought to the emergency department in a stupor was discovered to have suffered a large stroke.

15. Waisel DB, Truog RD. The cardiopulmonary resuscitation-not-indicated order: futility revisited. Ann Intern Med 122:304–308, 1995. 16. Sulmasy DP. The use and abuse of the principle of double effect. Clin Pulm Med 3:86–90, 1996. 17. Covinsky KE, Goldman L, Cook EF, Oye R, Desbiens N, Reding D, Fulkerson W, Connors AF, Lynn J, Phillips RS. The impact of serious illness on patients’ families. JAMA 272:1839–1844, 1994. 3 Drug Dosing and Life-Threatening Drug Reactions in the Critically Ill Patient Frances S.

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