Geriatric Assessment

What Is Geriatric Assessment?

A geriatric assessment is a specialized EMS evaluation protocol tailored for patients aged 65 and older, taking into account age-related physiological changes (blunted fever/tachycardia responses), atypical disease presentations, baseline cognitive status, medication polypharmacy, and fall risk factors.

Why Geriatric Assessment Matters on the Fireground

Elderly patients often present atypically — septic shock may manifest only as altered mental status without fever, and acute MI may present as vague weakness without chest pain. Specialized assessment prevents misdiagnosis and missed trauma.

Relevant NFPA Standards

• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards
• NFPA 455: Standard for Emergency Medical Services (EMS)

Field Procedures & Tactical Steps

1. Establish baseline cognitive function by consulting family members, caregivers, or home health records.
2. Gather a complete medication list (checking for blood thinners like warfarin/Eliquis that increase fatal bleed risk).
3. Perform a thorough head-to-toe examination for subtle trauma, skin breakdown, or occult fractures after a fall.
4. Assess vital signs carefully, remembering that beta-blockers may prevent compensatory tachycardia during shock.
5. Evaluate home safety conditions (environmental temperature, trip hazards, nourishment) and document social concerns.

Common Context & Application

Utilized on prehospital EMS calls involving elderly patients suffering falls, altered mental status, infection, or chronic illness decompensation.

Frequently Asked Questions about Geriatric Assessment