Vancouver IM LMR

Recently, Dr. Gurmeet Sohi, one of our VGH CTU Attending and Geriatricians, shared her approach to acute care medicine for geriatric patients.

Check out her full slide deck here

Here are some highlights from the incredibly informative talk:

• Anticoagulation in elderly patients – Consider low-dose Edoxaban, per the ELDERCARE-AF trial, full article link here.
• Importance of language – Using blanket terms like “Failure to Thrive” can be misleading. A matched case-control study from Vancouver found that 88% of patient’s labeled as “Failure to Thrive” had an acute medical diagnosis at time of discharge. Read the full paper here.
• Approach to falls:
  • Identify causes
    • Acute precipitants?
    • Intrinsic factors
      • Modifiable (medications, chronic diseases, visual/hearing impairment etc.,)
      • Non-modifiable (age, sex, prior history of falls)
    • Extrinsic factors
  • Assess for consequences
    • Bone safety
    • Home safety
    • Pain control
    • Reconditioning
  • Differentiating fall from syncope – history, history, and history!
  • The role of thorough physical exam, including a neuro exam
  • Key investigations to consider
  • Overview of fall management