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The elderly patient with back pain in the ED

Mx of the elderly:

essentials of ED Mx:
  • exclude AAA early - if epigastrium is tender discuss with ED consultant for urgent US or CT
  • if chest pain radiating to back - exclude dissection, PE, pneumothorax, etc.
  • urinalysis as above under adults
  • lower threshold for plain Xrays of Tx or Lx spine as even minor injury such as a trip/fall can cause a crush fracture in osteoporotic elderly or those with occult metastatic disease.
  • look carefully for neurology in lower limbs & esp. bladder/bowel dysfunction which may indicate acute spinal cord compression and need for urgent neurosurgical assessment.
  • take extra care in prescribing NSAID's - risk of gastric bleed; avoid if on ACE inhibitors as risk of renal failure.
backpain_elderly.txt · Last modified: 2008/11/05 12:40 (external edit)