Urgences et gériatrie

Emergency units are one of the main access roads to the hospital for the elderly. This population accumulates a certain number of problems. Ageing is characterized by a decrease in functional reserves, unmasked during acute situations in patients often exhibiting comorbidities. Their functional and social status is a key parameter to be taken into account. Their management in emergencies is difficult because of varied motives for consultation, lack of information, semiological atypia and a risk connected to polymedication. In spite of a generally very time-consuming evaluation, it is crucial to look for the maximum of information concerning the old patient, to screen for pathologies and also the patients and the situations at risk. A rigorous and systematic clinical examination as well as a minimum of biological examinations is required. A geriatric reasoning will permit the differentiation between ageing, chronic and acute pathology that should be pursued, because profitable in terms of diagnosis and treatment. Finally, it is necessary to anticipate the consequences of the passage in the emergency unit in terms of optimal orientation or organization of an adapted return to home.