Join Dr. Christina Shenvi and Dr. Teresita Hogan as they walk through the history of geriatric emergency medicine. Learn about the challenges, changes, and breakthroughs that have shaped this field over the past 40 years.

The Winding Road to Geriatric EM

In this episode of GEMCast Dr. Christina Shenvi is joined by Dr. Chris Carpenter to discuss GEAR 2.0-Advancing Dementia Care. Learn how GEAR 2.0 identified and prioritized research gaps in emergency care for persons living with dementia and their care partners.

Dementia Research in ED Settings

In this episode of GEMCast Dr. Christina Shenvi is joined by Pamela Martin and Dr. Ula Hwang to learn about Geriatric transitional care nurses and how they can be incorporated into an ED to improve care for older patients.

Geriatric Transitional Care Nurses and How They Could Help Your ED

Dr. Christina Shenvi is joined by Dr. Lucas Da Silva for a conversation about the concept of patient experience and why it is important to older adult care in the emergency department.

How Can We Improve the Patient Experience for Older Adults?

In this episode, GEMCast host Dr. Christina Shenvi is joined by Dr. Katie Buck to discuss the challenges surrounding diagnosing older adults with pneumonia.

Do You Know How to Diagnose Pneumonia in Older Patients?

Dr. Christina Shenvi sits down with Dr. Kerstin de Wit to learn how much anticoagulation matters in terms of increasing the risk of intracranial hemorrhage after a ground-level fall.

Do Anticoagulants Matter After a Head Injury?

Dr. Christina Shenvi and Dr. Robert Dachs discuss how ED clinicians can identify and manage vertebral compression fractures in older adults.

How to Diagnose and Manage Vertebral Compression Fractures in the ED

Dr. Christina Shenvi and Dr. Lauren Southerland have a conversation about self-neglect; a complicated geriatric syndrome that is both a diagnostic and care coordination challenge.

How to Identify and Intervene for Geriatric Self-Neglect

Dr. Shenvi is joined by Dr. Alice Gray and Dr. Brittany Ellis to discuss geriatric experiential education.

Geri Immersive Simulation

Dr. Shenvi sits down with Dr. Elizabeth Goldberg to discuss ways to prevent and manage falls for older adults in the ED.

How to Help Prevent the Next Fall in Your Older Patients

Welcome to GEMCAST! Shownotes and more info are available on https://gedcollaborative.com/resources/gemcast/ GEMCAST is a Geriatric Emergency Medicine Podcast created to help clinicians, nurses, or paramedics who take care of older adults, particularly in the Emergency Department setting. Welcome! I'm your host, Christina Shenvi. You can connect with me on twitter @clshenviDisclaimer: By listening to this podcast, you agree not to use this podcast or website as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall this podcast, website, or any contributors to it be responsible for damages arising from use of the podcast. Furthermore, this podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Being a nurse in an ED that has just started its “geriatric friendly” journey, this has been a great resource for me. Thank you!

Great resource for nurses

Welcome to GEMCAST! Shownotes and more info are available on <a href="https://gedcollaborative.com/resources/gemcast/" rel="nofollow" target="_blank">https://gedcollaborative.com/resources/gemcast/</a> GEMCAST is a Geriatric Emergency Medicine Podcast created to help clinicians, nurses, or paramedics who take care of older adults, particularly in the Emergency Department setting. Welcome! I'm your host, Christina Shenvi. You can connect with me on twitter @clshenvi Disclaimer: By listening to this podcast, you agree not to use this podcast or website as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall this podcast, website, or any contributors to it be responsible for damages arising from use of the podcast. Furthermore, this podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

GEMCAST

Zara Cooper is an acute care and trauma surgeon at the Brigham and Women's hospital. See www.gempodcast.com for full details and show notes.This podcast uses sounds from freesound.org by Jobro and HerbertBoland.Image is from: https://pixabay.com/en/heart-first-aid-medical-medicine-2730784/

Zara Cooper is an acute care and trauma surgeon at the Brigham and Women's hospital. See <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for full details and show notes. This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image is from: <a href="https://pixabay.com/en/heart-first-aid-medical-medicine-2730784/" rel="nofollow" target="_blank">https://pixabay.com/en/heart-first-aid-medical-medicine-2730784/</a>

Trauma in Older Adults

David Silfen, an EMS provider describes a program he has helped initiate to intervene with older adults who have a high falls risk.See www.gempodcast.com for full details and show notes.This podcast uses sounds from freesound.org by Jobro and HerbertBoland.Image credit: https://pixabay.com/en/step-falling-tripping-danger-98822/

David Silfen, an EMS provider describes a program he has helped initiate to intervene with older adults who have a high falls risk. See <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for full details and show notes. This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image credit: <a href="https://pixabay.com/en/step-falling-tripping-danger-98822/" rel="nofollow" target="_blank">https://pixabay.com/en/step-falling-tripping-danger-98822/</a>

Preventing Falls in the Elderly: an EMS story

Mary Mulcare and I talk about how to diagnose and treat UTIs, the dangers of catheters, and how to protocolize catheter reduction. See https://gempodcast.com/2018/02/02/utis-in-older-adults/ for show notes, more info, and references.

Mary Mulcare and I talk about how to diagnose and treat UTIs, the dangers of catheters, and how to protocolize catheter reduction. See <a href="https://gempodcast.com/2018/02/02/utis-in-older-adults/" rel="nofollow" target="_blank">https://gempodcast.com/2018/02/02/utis-in-older-adults/</a> for show notes, more info, and references.

UTIs In The Elderly

Dr. Alisha Benner discusses tips for palliative care in the ED. see www.gempodcast.com for show notes, references, information, and to leave comments! Follow @gempodcast on twitter.This podcast uses sounds from freesound.org by Jobro and HerbertBoland.Image credit: https://commons.wikimedia.org/wiki/File:Dante_Gabriel_Rossetti_-_Study_of_Dante_holding_the_hand_of_Love.jpg

Dr. Alisha Benner discusses tips for palliative care in the ED. see <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for show notes, references, information, and to leave comments! Follow @gempodcast on twitter. This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image credit: <a href="https://commons.wikimedia.org/wiki/File:Dante_Gabriel_Rossetti_-_Study_of_Dante_holding_the_hand_of_Love.jpg" rel="nofollow" target="_blank">https://commons.wikimedia.org/wiki/File:Dante_Gabriel_Rossetti_-_Study_of_Dante_holding_the_hand_of_Love.jpg</a>

Practical Tips for Palliative Care in the ED

Amal Mattu talks about ACS presentations, workup, and management in older adults, and why the atypical is typical!For the full shownotes and references, and to leave a comment, see: https://gempodcast.comChest pain is one of the most common reasons why people present to the ED. The chief complaint of Chest Pain typically triggers an automatic EKG, and potentially a workup for acute coronary syndrome. However, many patients who are having ACS do not present with chest pain. Instead, they may have dyspnea, diaphoresis, nausea, vomiting, abdominal pain, or other non-specific symptoms. Which patients are most likely to present this way? Older adults. And the older the patient, the more likely they are to be chest-pain free when they present with an NSTEMI or STEMI. So it is up to the medical provider to be vigilant, consider possible angina equivalents, and order the right workup. Dr. Mattu talks us through some of the statistics of how often MIs occur without chest pain with age, how EKG interpretation may differ, and how management should differ vs how it does differ. Patients presenting with atypical symptoms are less likely to receive an aspirin or thrombolytics/PCI, and their mortality is higher. Selected References: 1. Mattu A, Grossman SA, Rose PL. Geriatric emergencies - A discussion-based review. Wiley Blackwell; 2016. 2. Glickman SW, Shofer FS, Wu MC, et al. Development and validation of a prioritization rule for obtaining an immediate 12-lead electrocardiogram in the emergency department to identify ST-elevation myocardial infarction. Am Heart J. 2012;163(3):372-382. http://www.ncbi.nlm.nih.gov/pubmed/224240073. Brieger D, Eagle KA, Goodman SG, et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: Insights from the global registry of acute coronary events. Chest. 2004;126(2):461-469. http://www.ncbi.nlm.nih.gov/pubmed/153027324. Cannon AR, Lin L, Lytle B, Peterson ED, Cairns CB, Glickman SW. Use of prehospital 12-lead electrocardiography and treatment times among ST-elevation myocardial infarction patients with atypical symptoms. Acad Emerg Med. 2014;21(8):892-898. http://www.ncbi.nlm.nih.gov/pubmed/251552895. Alexander KP, Newby LK, Cannon CP, et al. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: A scientific statement for healthcare professionals from the american heart association council on clinical cardiology: In collaboration with the society of geriatric cardiology. Circulation. 2007;115(19):2549-2569. http://www.ncbi.nlm.nih.gov/pubmed/175025906. Canto JG, Rogers WJ, Goldberg RJ, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012;307(8):813-822. http://www.ncbi.nlm.nih.gov/pubmed/22357832 This podcast uses sounds from freesound.org by Jobro and HerbertBoland. Image credit: https://pixabay.com/en/pulse-trace-healthcare-medicine-163708/

Amal Mattu talks about ACS presentations, workup, and management in older adults, and why the atypical is typical! For the full shownotes and references, and to leave a comment, see: <a href="https://gempodcast.com" rel="nofollow" target="_blank">https://gempodcast.com</a> Chest pain is one of the most common reasons why people present to the ED. The chief complaint of Chest Pain typically triggers an automatic EKG, and potentially a workup for acute coronary syndrome. However, many patients who are having ACS do not present with chest pain. Instead, they may have dyspnea, diaphoresis, nausea, vomiting, abdominal pain, or other non-specific symptoms. Which patients are most likely to present this way? Older adults. And the older the patient, the more likely they are to be chest-pain free when they present with an NSTEMI or STEMI. So it is up to the medical provider to be vigilant, consider possible angina equivalents, and order the right workup. Dr. Mattu talks us through some of the statistics of how often MIs occur without chest pain with age, how EKG interpretation may differ, and how management should differ vs how it does differ. Patients presenting with atypical symptoms are less likely to receive an aspirin or thrombolytics/PCI, and their mortality is higher. Selected References: 1. Mattu A, Grossman SA, Rose PL. Geriatric emergencies - A discussion-based review. Wiley Blackwell; 2016. 2. Glickman SW, Shofer FS, Wu MC, et al. Development and validation of a prioritization rule for obtaining an immediate 12-lead electrocardiogram in the emergency department to identify ST-elevation myocardial infarction. Am Heart J. 2012;163(3):372-382. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22424007" rel="nofollow" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/22424007</a> 3. Brieger D, Eagle KA, Goodman SG, et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: Insights from the global registry of acute coronary events. Chest. 2004;126(2):461-469. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15302732" rel="nofollow" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/15302732</a> 4. Cannon AR, Lin L, Lytle B, Peterson ED, Cairns CB, Glickman SW. Use of prehospital 12-lead electrocardiography and treatment times among ST-elevation myocardial infarction patients with atypical symptoms. Acad Emerg Med. 2014;21(8):892-898. <a href="http://www.ncbi.nlm.nih.gov/pubmed/25155289" rel="nofollow" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/25155289</a> 5. Alexander KP, Newby LK, Cannon CP, et al. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: A scientific statement for healthcare professionals from the american heart association council on clinical cardiology: In collaboration with the society of geriatric cardiology. Circulation. 2007;115(19):2549-2569. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17502590" rel="nofollow" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/17502590</a> 6. Canto JG, Rogers WJ, Goldberg RJ, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012;307(8):813-822. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22357832" rel="nofollow" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/22357832</a> This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image credit: <a href="https://pixabay.com/en/pulse-trace-healthcare-medicine-163708/" rel="nofollow" target="_blank">https://pixabay.com/en/pulse-trace-healthcare-medicine-163708/</a>

The Atypical is Typical for ACS in Older Adults

Leah Hatfield and I discuss the potential benefits of clevidipine for management of Hypertensive Emergencies. Learn more about indications, dosing, titration, and potential contra-indications. For full shownotes, credits, and references, see www.gempodcast.com

Leah Hatfield and I discuss the potential benefits of clevidipine for management of Hypertensive Emergencies. Learn more about indications, dosing, titration, and potential contra-indications. For full shownotes, credits, and references, see <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a>

Hypertensive Emergencies Management with Clevidipine

Dr. Lauren Southerland and I discuss her recent paper on the importance of and how to do a discharge risk assessment in elderly patients in the ED. For more, go to www.gempodcast.com

Dr. Lauren Southerland and I discuss her recent paper on the importance of and how to do a discharge risk assessment in elderly patients in the ED. For more, go to <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a>

How to Do a Discharge Risk Assessment

Chris Carpenter discusses the new ACEP accreditation of Geriatric EDs and what your ED would need to do to become accredited. See www.gempodcast.com for full shownotes and more info or to leave a comment.Music credit: Bob Dylan, The Times They Are Changing, 1964, Columbia Records

Chris Carpenter discusses the new ACEP accreditation of Geriatric EDs and what your ED would need to do to become accredited. See <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for full shownotes and more info or to leave a comment. Music credit: Bob Dylan, The Times They Are Changing, 1964, Columbia Records

Geriatric ED Accreditation - And Why You Should Care

Dr. Sandy Schneider and I discuss a new toll released by ACEP for assessing and managing older adults with agitation and confusion. See the full show notes at www.gempodcast.com.The tool is available at www.acep.org/adept

Dr. Sandy Schneider and I discuss a new toll released by ACEP for assessing and managing older adults with agitation and confusion. See the full show notes at <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a>. The tool is available at <a href="http://www.acep.org/adept" rel="nofollow" target="_blank">www.acep.org/adept</a>

ADEPT

Leah Hatfield discusses the new oral anticoagulants, and how to reverse them in cases of life threatening bleeds. To leave a comment and for the shownotes, see https://gempodcast.com/2016/09/30/how-to-reverse-oral-anticoagulants/

Leah Hatfield discusses the new oral anticoagulants, and how to reverse them in cases of life threatening bleeds. To leave a comment and for the shownotes, see <a href="https://gempodcast.com/2016/09/30/how-to-reverse-oral-anticoagulants/" rel="nofollow" target="_blank">https://gempodcast.com/2016/09/30/how-to-reverse-oral-anticoagulants/</a>

How to Reverse Oral Anticoagulants

Tony Rosen discusses how to identify elder abuse and ways to intervene. Elder abuse is a common and under-recognized problem among older adults. In the Emergency Department, we are uniquely positioned to identify patients who may be at risk. In this episode, Tony Rosen, an Emergency Physician and researcher with fellowship training in Geriatric Emergency Medicine, who works at Cornell in NYC discusses what constitutes elder abuse, its prevalence, how to identify it, and what to do when you suspect it.For State requirements, see here: http://www.napsa-now.org/wp-content/uploads/2014/11/Mandatory-Reporting-Chart-Updated-FINAL.pdfPlease see https://gempodcast.com/2016/08/26/how-to-identify-and-intervene-in-cases-of-elder-abuse/ for the full show notes and references.

Tony Rosen discusses how to identify elder abuse and ways to intervene. Elder abuse is a common and under-recognized problem among older adults. In the Emergency Department, we are uniquely positioned to identify patients who may be at risk. In this episode, Tony Rosen, an Emergency Physician and researcher with fellowship training in Geriatric Emergency Medicine, who works at Cornell in NYC discusses what constitutes elder abuse, its prevalence, how to identify it, and what to do when you suspect it. For State requirements, see here: <a href="http://www.napsa-now.org/wp-content/uploads/2014/11/Mandatory-Reporting-Chart-Updated-FINAL.pdf" rel="nofollow" target="_blank">http://www.napsa-now.org/wp-content/uploads/2014/11/Mandatory-Reporting-Chart-Updated-FINAL.pdf</a> Please see <a href="https://gempodcast.com/2016/08/26/how-to-identify-and-intervene-in-cases-of-elder-abuse/" rel="nofollow" target="_blank">https://gempodcast.com/2016/08/26/how-to-identify-and-intervene-in-cases-of-elder-abuse/</a> for the full show notes and references.

How to Identify and Intervene in Cases of Elder Abuse

Ophthalmologist Dr. Bryan Hong continues to discuss his approach to some of the common eye emergencies that bring older adults to the Emergency Department.see www.gempodcast.com for show notes and information and to leave comments.This podcast uses sounds from freesound.org by Jobro and HerbertBoland.Image credit: https://pixabay.com/en/eye-black-reds-female-red-color-1574829/

Ophthalmologist Dr. Bryan Hong continues to discuss his approach to some of the common eye emergencies that bring older adults to the Emergency Department. see <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for show notes and information and to leave comments. This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image credit: <a href="https://pixabay.com/en/eye-black-reds-female-red-color-1574829/" rel="nofollow" target="_blank">https://pixabay.com/en/eye-black-reds-female-red-color-1574829/</a>

Eye Emergencies in the Elderly - Part 2

Ophthalmologist Dr. Bryan Hong talks about his approach to some of the common eye emergencies that bring older adults to the Emergency Department. see www.gempodcast.com for show notes and information and to leave comments.This podcast uses sounds from freesound.org by Jobro and HerbertBoland. Image credit: https://commons.wikimedia.org/wiki/File:A_selection_of_glass_eyes_from_an_opticians_glas_eye_case._Wellcome_L0036581.jpg

Ophthalmologist Dr. Bryan Hong talks about his approach to some of the common eye emergencies that bring older adults to the Emergency Department. see <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for show notes and information and to leave comments. This podcast uses sounds from <a href="http://freesound.org" rel="nofollow" target="_blank">freesound.org</a> by Jobro and HerbertBoland. Image credit: <a href="https://commons.wikimedia.org/wiki/File:A_selection_of_glass_eyes_from_an_opticians_glas_eye_case._Wellcome_L0036581.jpg" rel="nofollow" target="_blank">https://commons.wikimedia.org/wiki/File:A_selection_of_glass_eyes_from_an_opticians_glas_eye_case._Wellcome_L0036581.jpg</a>

Eye Emergencies in the Elderly - Part 1

Drs. Ferdinando Mirarchi and Marie-Carmelle Elie explain the meaning and ramifications of different types of advance care planning orders and what they mean to physicians, APPs, or nurses caring for patients.Image credit: pixabay.com/photos/business-signature-contract-962355/Sound credit:www.freesound.org/people/HerbertBoland/sounds/128544/

Drs. Ferdinando Mirarchi and Marie-Carmelle Elie explain the meaning and ramifications of different types of advance care planning orders and what they mean to physicians, APPs, or nurses caring for patients. Image credit: <a href="http://pixabay.com/photos/business-signature-contract-962355/" rel="nofollow" target="_blank">pixabay.com/photos/business-signature-contract-962355/</a> Sound credit:<a href="http://www.freesound.org/people/HerbertBoland/sounds/128544/" rel="nofollow" target="_blank">www.freesound.org/people/HerbertBoland/sounds/128544/</a>

Advance Care Planning - What does it all mean?

Maura Kennedy discusses a recent paper on orthostatic vital signs. The conclusions may surprise you! See www.gempodcast.com for more info and the paper reference.

Maura Kennedy discusses a recent paper on orthostatic vital signs. The conclusions may surprise you! See <a href="http://www.gempodcast.com" rel="nofollow" target="_blank">www.gempodcast.com</a> for more info and the paper reference.

Are Orthostatic Vital Signs Helpful in the ED?

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Best Episodes on Self Improvement, Growth & Development

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