Do You Know How to Diagnose Pneumonia in Older Patients?
With Katie Buck
Pneumonia is the most common infection in older adults, accounting for over half a million ED visits annually. However, older adults have many characteristics, such as atypical symptoms, imaging inaccuracy, comorbidities, etc. that make diagnostics (especially dyspnea/pneumonia) more difficult.
In this episode, GEMCast host Dr. Christina Shenvi is joined by Dr. Katie Buck to discuss the challenges surrounding diagnosing older adults with pneumonia and dyspnea as well as the impact of misdiagnosis.
Key Points
- Some Dx will be slam dunk. Pneumonia is a challenging diagnosis in older adults for many reasons.
- Avoid premature diagnostic closure
- Remain vigilant and consider pneumonia even with an atypical presentation (similar to how we consider MI with atypical symptoms).
- Be a detective to get to the bottom of the symptoms.
- EXPRESS UNCERTAINTY – avoid conveyer belt med
References
- Hunold KM, Schwaderer AL, Exline M, Hebert C, Lampert BC, Southerland LT, Stephens JA, Bischof JJ, Caterino JM. Diagnosing Dyspneic Older Adult Emergency Department Patients: A Pilot Study. Acad Emerg Med. 2021 Jun;28(6):675-678. doi: 10.1111/acem.14183. Epub 2020 Dec 16. PMID: 33249675. – View Article
- ylvester PJ, Stewart J, Schoeffler A, Aalberg J, Hunold KM, Caterino JM, Bischof JJ. Utility of Emergency Department Chest Imaging in Patients with Cancer: A Descriptive Study. J Emerg Med. 2020 Sep;59(3):396-402. doi: 10.1016/j.jemermed.2020.05.007. Epub 2020 Jun 24. PMID: 32593580; PMCID: PMC7606423. – View Article
- Caterino JM, Kline DM, Leininger R, Southerland LT, Carpenter CR, Baugh CW, Pallin DJ, Hunold KM, Stevenson KB. Nonspecific Symptoms Lack Diagnostic Accuracy for Infection in Older Patients in the Emergency Department. J Am Geriatr Soc. 2019 Mar;67(3):484-492. doi: 10.1111/jgs.15679. Epub 2018 Nov 22. PMID: 30467825; PMCID: PMC6403002. – View Article