Background: Third and fourth year medical students’ experience on general internal medicine ward teams is an integral part of medical student education. At many institutions this experience includes participation in unit based Care Coordination Rounds (CCRs), including our own. These daily multidisciplinary discharge planning meetings are ubiquitous, however students are often uncomfortable presenting at these […]

Background: Prolongation of the QT interval is associated with adverse cardiac events, mainly a distinctive ventricular tachycardia known as Torsades de Pointes. Prolonged QT can be congenital or acquired and is OFTEN measured as a corrected QT interval of >450 msec for men and >470 msec for women. In a world where medical knowledge and […]

Background: Introduction : A Medical Orders for Scope of Treatment (MOST) form, adopted by the state of Texas in 2014, is similar to Physician Orders for Life Sustaining Treatment (POLST/MOLST) form in other states. It translates patient preferences for CPR, critical care, assisted nutrition, and transfer between healthcare facilities into a physician order set. Previous […]

Background: As the United States population ages the health care system is experiencing overall change and growth in the patient population as evidenced by the rising demand of psychiatric care in the emergency department. By the year 2029 “baby boomers” or older adults, those born between mid-1946 through mid-1964, will be 65 and older resulting […]

Background: Delirium is a common and costly occurrence in hospitalized patients, particularly elderly patients. Diagnosing delirium can be challenging, particularly given the fluctuating nature of presentation and subtle hypoactive motor subtypes. The Brief Confusion Assessment Method (bCAM) is a delirium screening tool that has been validated for use in the med-surg clinical area. As part […]

Background: Patients with Alzheimer’s disease and related dementias (ADRD) account for 3.2 million hospital admissions per year; they have over three times more hospitalizations than persons without cognitive impairment. Hospitalization in these patients is a seminal event that often leads to delirium, lasting functional and cognitive impairment, institutionalization, premature death, increased resource consumption, and family […]

Background: In medical care for older patients, the presence of potentially inappropriate medications (PIMs) is associated with increased adverse outcomes [1, 2]. A wide range of medications with anticholinergic properties affects cognitive states of older patients have been regarded as PIMs [1, 3]. We purposed to assess clinical impact of anticholinergic cognitive burden on clinical […]

Background: Although many older adults will be hospitalized in their lifetime, most do not consider or plan ahead for their post-hospitalization support needs. When older adults experience a hospitalization, families often must react to the crisis leaving the older adult out of the decision process (e.g. choosing a skilled nursing facility, caregivers). With PCORI funding, […]

Background: The relation of a patient’s age to survival in cardiac arrest is often discussed at the bedside when clinicians, patients, and families are faced with the question of whether CPR is medically appropriate for elderly individuals. Few studies are available to help guide this conversation. This study sought to evaluate in-hospital cardiac arrest (IHCA) […]

Background: Atrial fibrillation (AF) is strongly age-dependent, and with a growing geriatric population, the incidence and prevalence of AF is expected to increase in the United States. As a result, the number of patients at risk of a thromboembolic event due to AF is also expected to increase. Although bleeding associated with mechanical falls is […]