Acute dyspnea in older patients is a common presentation to the emergency department. Acute dyspnea in older adults is often the consequence of multiple overlapping disorders, such as pneumonia precipitating acute heart failure. Emergency physicians must be comfortable managing patients with acute dyspnea of uncertain cause and varying goals of care. In addition to the important role noninvasive ventilation (NIV) plays in full resuscitation, NIV can be useful as a method of providing supportive or nearly fully supportive care while more information is gathered from the patients and their loved ones.
Key points
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Almost every disease process that primarily affects the lung is more common in older patients.
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Even in healthy older adults, there are significant age-related lung changes.
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Influenza is estimated to cause 35,000 deaths annually in older patients in the United States.
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Chronic obstructive pulmonary disease (COPD) accounts for nearly 20% of all hospital admissions in people 65 to 75 years old.
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Short courses of antibiotics are as effective as longer courses for acute exacerbations of COPD.
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Age-adjusted D-dimer values have been validated and are likely to be increasingly incorporated into clinical decision rules.
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Emergency departments are the first entry into the health care system for 80% of patients with acute heart failure.
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Noninvasive ventilation should be used early and liberally for patients with acute respiratory failure.
Related posts:
Early Treatment of Severe Acute Respiratory Distress Syndrome
Management of Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease in the Emergency Department
Noninvasive Ventilation for the Emergency Physician
Approach to Adult Patients with Acute Dyspnea
Airway Management of Respiratory Failure
Advances in Point-of-Care Thoracic Ultrasound
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