The Pre-hospital geriatric care essentials programme develops clinicians capable of assessing and managing the complex medical, traumatic, psychological, social and palliative needs of older people in the pre-hospital environment.
The objective is not merely to identify geriatric disease. It is to understand the person experiencing it.
By completion, participants should be able to:
• Describe clinically important physiological changes associated with ageing.
• Recognise how ageing alters presentation and physiological response to illness.
• Undertake a structured assessment of an older patient.
• Establish an older person's baseline cognition, mobility and functional status.
• Recognise frailty and understand its relevance to emergency care.
• Distinguish frailty from chronological age.
• Recognise atypical presentations of serious illness.
• Differentiate delirium, dementia and other causes of altered cognition.
• Assess falls as both traumatic events and potential symptoms of underlying illness.
• Understand the consequences of polypharmacy and altered pharmacokinetics.
• Recognise medication-related emergencies and toxicity.
• Assess respiratory, cardiovascular, neurological and other common geriatric emergencies.
• Recognise dehydration, infection and metabolic illness in older people.
• Identify potential elder maltreatment, neglect and unsafe environments.
• Communicate effectively with older people experiencing sensory or cognitive impairment.
• Appropriately involve family and carers without excluding the patient.
• Make proportionate and patient-centred transport decisions.
• Recognise patients approaching the end of life.
• Understand the principles of palliative and end-of-life emergency care.
• Establish goals of care and determine what matters to the patient.
• Manage common end-of-life symptoms.
• Recognise when hospital transfer may not align with the patient's goals of care.
• Communicate effectively with patients and families during end-of-life situations.
• Integrate dignity, autonomy and comfort into emergency decision-making.
• Apply clinical reasoning during geriatric simulations.
Paramedics, nurses, emergency clinicians, retrieval clinicians and other healthcare professionals caring for older people in emergency and pre-hospital environments.
Case-based learning, practical assessment, communication exercises, equipment workshops and realistic simulation.
The older patient Is different
Geriatric assessment: Look beyond the complaint
Frailty, function & physiological reserve
Polypharmacy & medication-related emergencies
Delirium, dementia & neurological emergencies
Respiratory & cardiovascular emergencies
Falls & geriatric trauma
Infection, dehydration & other medical presentations
Medical devices, skin & the home environment
Psychosocial emergencies, capacity & communication
Elder maltreatment, neglect & safeguarding
Transport, non-transport & destination decisions
Introduction to palliative & end-of-life care
Managing symptoms at the end of life
Goals of care, advance care planning & decision-making
Communication with patients & families
Integrated geriatric simulations
