Geriatric EMS
Geriatric patients present atypically, decompensate quickly, and take more medications than any other population. Recognize the subtle presentations before the vital signs catch up.
EMT · AEMT · Paramedic
Atypical presentations
MI in the elderly often looks like weakness, syncope, or acute confusion — not chest pain. Infection can present as a single altered-mental-status episode. Any acute change from baseline in a geriatric patient deserves a full workup and transport.
Falls are never just falls
80% of geriatric falls have a medical cause — syncope, arrhythmia, orthostasis, hypoglycemia, stroke. Full trauma workup PLUS a medical workup, medication review, and social assessment.
Polypharmacy
The average 75-year-old takes 5+ prescriptions. Look for beta-blockers (mask tachycardia), anticoagulants (worsen bleeding), diuretics (dehydration), and PDE-5 inhibitors (nitro contraindication). Bring the medication list to the hospital.
Elder abuse and end-of-life
Unexplained bruising, pressure ulcers, dehydration, or fear of the caregiver are red flags — document and report per state law. Respect valid DNR/POLST orders; if the paperwork is unclear, resuscitate and sort it out at the hospital.
Frequently asked
- Why does an elderly patient with pneumonia look 'just confused'?
- The febrile response and pain response blunt with age. Delirium is often the only presenting sign of serious infection.
- Do I honor a DNR without paperwork on scene?
- No — begin resuscitation and let the hospital or medical direction sort out validity. A verbal report from family is not sufficient in most systems.
Test yourself
Practice on this topic.
Free 10-question sample or build a custom quiz on geriatric ems.