Why is Geriatric Emergency Medicine important?
Emergency Medicine is implemented as a primary specialty in many countries in Europe and all over the world. Efforts have been focused on setting design, organization of pre-hospital systems and emergency departments (ED) and improve outcomes of life-threatening conditions like myocardial infarction or trauma. Despite all international multicentric studies including all ages of patients, attention towards older patients remains still low although they represent one of the most important groups because of the changing population demographics.
ED visit of older patients are always a crisis for them because three dimensions are involved; social, somatic, and psychological. The WHO definition of older people starts from 60 years old but problems are critical for older patients over 75 years of age who experience loss of
autonomy, difficulties of stay at home, and cognitive deficiencies (eg dementia). Emergency care of older people will increase exponentially because the number of old people will increase for the next 50 years. This evolution will generate increase of health demand in emergency medicine settings and significant increase of health cost at the national and global level. In 2050, the number of people over the age of 85 will outnumber those under 16. Europe has 23 of the world’s 25 “oldest” countries.
Beside specific studies done by geriatricians little is known on geriatric emergency medicine (GEM). Relevant data and registries are still missing in the context of pre hospital and ED care management. GEM is a specific area which is of interest for emergency physicians and geriatricians.
The mission of this new EUSEM section is to develop GEM with collaboration between emergency physicians and geriatricians involved in two different societies, European Society for Emergency Medicine (EUSEM) and European Union of Geriatric Emergency Medicine
Society (EUGMS) which have a common objective to improve the quality of older patients emergency care. One of the originality of this approach compared to other EUSEM sections is the creation of a unique group including emergency physicians and geriatricians, leaders and members of EUSEM and EUGMS that will dedicate its effort on the development of GEM.
The objective is to concentrate concepts and goals avoiding overlap and repetition. Merging the two expertise will give more power and will help to achieve missions at the European Union and Global level. This group will focus on three domains, Organisation, Education and Research. The following will develop the status of this section.
- To propose guidelines and spread existing guidelines relevant to older people in pre-hospital care and emergency departments.
- To develop guidance on educational and service delivery programmes to improve care of older people in emergency departments.
- To develop collaboration with other societies active in influencing care of older people in emergency departments. This includes European organisations including the European Union Geriatric Medicine Society (EUGMS), the International
- Collaboration in Emergency Geriatrics and geriatric emergency medicine chapters of other European and international organisations to propose quality improvement and clinical research studies on older people in the pre-hospital and ED settings.
- To consult, deliberate and provide guidance on definitions, scope of practice and terms of reference of geriatric emergency care in emergency departments.
- To define the emerging subspecialty of Geriatric Emergency Medicine (GEM) for member European Union countries.
Education and Training
The principal goal of the section is to implement educational programmes on GEM for clinicians and allied health professionals. Educational events will be planned every year:
- Workshops on GEM during EUSEM congress
- Two sessions of four talks (State of the Art and Clinical questions) on GEM during EUSEM congresses
- Joint session during the EUGMS congress.
- Propose a specific 2-days event focused on GEM organized by the section during the year. This event will be named EuSGEM/EUGEM Summit.
- To propose a curriculum on GEM that will be included in the European EM Curriculum.
- EUSEM has adopted EnlightenME from the UK College of Emergency Medicine as the online learning platform. This will include a section on Geriatric Emergency Medicine.
The section will:
- Review existing guidelines specifically related to the care of older people in pre-hospital and EDs. These guidelines should be made available in the webpage for the EUGMS/EuSGEM members. We will ask the European Emergency Medicine National Societies on what they are doing for improving the quality of older people care. A European book on GEM will be proposed.
- List new guidelines that should be proposed by the section and prioritization of one every two or three years. A task force should be defined including experts and written in collaboration with EuSGEM and the EUGMS GEM interest group. We will also work with EM societies from North America and IFEM to bring a global vision on GEM.
The section will implement a strategy for developing GEM Research. The first study will be a survey in Europe describing the older people managed in EM settings. This study will be done through European National Societies. This study could be the first step of a specific EU FP7. Many areas of research could be explored on: care organization and quality care, impact on morbidity-mortality of models management (role of network, ambulatory care…), boarder older patients, specific EM fields (ACS, stroke, sepsis, trauma…). This chapter will be discussed with the EUSEM Research committee to see how we can build GEM registries.