๋…ธ์ธ์‘๊ธ‰์˜ํ•™ / Geriatric emergency medicine

์ •์˜

๊ณ ๋ น ์‘๊ธ‰ํ™˜์ž์—์„œ frailty, delirium, ๋น„์ „ํ˜•์  ์ฆ์ƒ, ๊ธฐ๋Šฅ์ €ํ•˜, ํ‡ด์› ์‹คํŒจ๋ฅผ ํ•จ๊ป˜ ๋‹ค๋ฃจ๋Š” ์‘๊ธ‰์˜ํ•™ ์˜์—ญ.

์ž„์ƒ ํ•ต์‹ฌ

๊ณ ๋ นํ™”๋กœ ํ™˜์ž ์ˆ˜๊ฐ€ ๊ณ„์† ์ฆ๊ฐ€ํ•˜๋ฉฐ ์‘๊ธ‰์‹ค ์˜์‚ฌ๊ฒฐ์ •์ด ์–ด๋ ต๋‹ค. ๊ฐ์—ผ, ์‹ค์‹ , ๋ณตํ†ต, ์˜์‹๋ณ€ํ™”, ํ‡ด์› ๊ฐ€๋Šฅ์„ฑ ํŒ๋‹จ์ด ์ฃผ์š” ์ถ•์ด๋‹ค. Frailty๋Š” ICU admission, mortality, 72h revisit, functional decline ์˜ˆ์ธก ๋ณ€์ˆ˜๋กœ ์—ฐ๊ตฌ ๊ฐ€๋Šฅํ•˜๋‹ค. Delirium์€ occult infection ๋˜๋Š” sepsis์˜ ํ‘œํ˜„ํ˜•์ผ ์ˆ˜ ์žˆ๋‹ค.

์ง„๋‹จ

์‘๊ธ‰์‹ค delirium screening, frailty screening, atypical presentation ํ‰๊ฐ€๊ฐ€ ํ•ต์‹ฌ์ด๋‹ค. ๋ฐœ์—ด ์—†๋Š” sepsis, ๊ณ ๋ น ๋ณตํ†ต์˜ missed surgical abdomen, ๊ณ ๋ น syncope์˜ serious outcome์„ ๋ณ„๋„๋กœ ๋ณด์•„์•ผ ํ•œ๋‹ค.

์น˜๋ฃŒ

ํŠน์ • ์น˜๋ฃŒ๋ณด๋‹ค disposition tool, screening pathway, ํ˜‘์ง„ ๋ฐ ์ถ”์  outcome ์„ค๊ณ„๊ฐ€ ์ค‘์š”ํ•˜๋‹ค. Delirium/frailty screening pathway๋Š” intervention ์—ฐ๊ตฌ ์ฃผ์ œ๊ฐ€ ๋  ์ˆ˜ ์žˆ๋‹ค.

์ถœ์ฒ˜

ACEP geriatric ED guideline; SAEM geriatric EM ์ž๋ฃŒ.

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.