COVID-19 in Older Adults: Key Points for ED Providers

Summary

On March 30, 2020, the GEDC hosted a webinar on COVID-19 in Older Adults: Key Points for ED Providers. Over 380 participants from 15 countries participated in the webinar. The slides and video are available above for your use. Please share widely.

Some key points:

From the opening panel of Dr. Malone, Hogan, and Perry (8:30-25:00):

• attention to atypical presentations (we know that older people often don’t mount a fever with infections;
• the need for optimism (while mortality rate is 15% among people over 80, that means that 85% of them survive!);
• the importance of improved transitions of care (especially with nursing homes – consider developing a system to “forward triage” transfers from NHs through direct communication by NH physician with NH physician)

From our critical care expert, Dr. Kusum Mathews (25:00-38:00):

• guidance around clinical presentation
• suggestions around systems re-organization
• information about who needs intubation, differences in intubation techniques, ventilator settings

From our palliative care expert, Dr. Martine Sanon (38:00-54:00):

• guides to advanced care planning
• tools to guide geriatric assessments and to assess frailty
• resources for critical conversations around ACP and end-of-life decision-making
• practical pointers about symptom management.

Details

Moderator

Dr. Don Melady, MSc(ED) MD CCFP(EM)(COE) FCFP

Expert Panel

Panellists will include national and international experts in ED care, critical care, and palliative care, including the authors of
COVID-19 in Older Adults: Key Points for Emergency Department Providers:

• Dr. Teresita Hogan, MD, emergency physician
• Dr. Michael Malone, MD, geriatrician
• Dr. Adam Perry, MD, emergency physician and geriatrician
• Dr. Kusum Mathews, MD, critical care physician
• Dr. Emily Chai, MD, palliative care physician
• Dr. Martine Sanon, MD, palliative care physician

Goals

 To provide guidance from palliative care physicians on key points around goals of care conversations, advanced care planning (in the ED), and symptom management in COVID-19 patients.

To introduce emergency physicians to the epidemiology and clinical presentation of COVID-19 especially in older patients.

To provide a forum for discussion of the 15 key points in the article COVID-19 in Older Adults: Key Points for Emergency Department Providers

To provide guidance from a critical care physician on key points in the clinical management of older ED patients with COVID-19.

Meet the Moderator and GEDC Faculty on the Expert Panel

Don Melady

MD

Bio

Dr. Don Melady is an emergency physician at Mount Sinai Hospital in Toronto, Canada and a founding member of the Geriatric Emergency Department Collaborative. He is the author of the website www.geri-EM.com – a CME accredited program for geriatric emergency medicine education – and the chair of the Geriatric EM committee of the International Federation of Emergency Medicine.

Geri-EM.com Geriatric-ED.com Publications

Teresita Hogan

MD, FACEP

Bio

Dr. Teresita Hogan is a Professor of Medicine and Director of Geriatric Emergency Medicine at the University of Chicago Medicine. Her clinical research interest are Geriatric EM, Quality Improvement, Emergency Pain Management, Emergency Management of Falls in Older Adults, and Models of Care. Dr. Hogan is the ACEP representative to the AGS and serves on the executive committee Section for Enhancing Geriatric Understanding and Expertise among Surgical and Medical Specialists. She is an expert in graduate medical education and led the expert consensus process to establish The Geriatric Competencies for Emergency Medicine Residents.

She has also worked on identifying the number and characteristics of geriatric emergency departments across the United States and is a member of the GEDA Board of Governors.

Publications

Michael Malone

MD

Bio

Dr. Michael Malone is the Medical Director of Aurora Health Care – Senior Services and the Aurora at Home. He is a Clinical Adjunct Professor of Medicine at the University of Wisconsin School of Medicine and Public Health. He also serves as the Director of the Geriatrics Fellowship Program at Aurora Health Care. Dr. Malone received his undergraduate and medical degrees from Texas Tech University in Lubbock, Texas; he completed his internal medicine residency and geriatric fellowship training at Mt. Sinai Medical Center in Milwaukee. His Aurora Health Care practice is to home-bound older persons in inner-city Milwaukee.

Selected Publications

Adam Perry

MD

Bio

Dr. Adam Perry is a community emergency physician and fellowship-trained geriatrician. Current positions include faculty with The Geriatric Emergency Department Collaborative; reviewer with ACEP’s Geriatric Emergency Department Accreditation program; educational consultant; and independently-contracted emergency physician with Commonwealth Health System in Northeastern Pennsylvania. He has worked emergency departments ranging from rural “critical access” to urban trauma centres; as well as in Post-Acute and Long-Term Care, and house call medicine.

Publications