A new study from the University of North Carolina at Chapel Jill indicates a disparity when it comes to treatment of the elderly in most hospital emergency rooms. The 7 year study found that 49% of patients over the age of 75 were given pain medication in the ER "when needed." That compares to 65% of patients under the age of 75. This did not include patients who were cognitively impaired or could not tell personnel they were in pain.
Dr. Sherrie Squyres is an emergency room physician at Huntsville Hospital.
"It's a very large study done with thousands of patients in North Carolina, and they have a wonderful emergency medicine program there. It's one of the better teaching programs for emergency medicine in the country," said Squyres.
Squyres says advanced age is a legitimate reason for doctors to be cautious.
"Because in that age group, many of the patients have liver disease or renal disease that impairs the metabolism of those drugs, so they metabolize them differently than in younger people. The same dose of medication that I could give a 40-year-old, may make an 80-year-old stop breathing," she said.
Squyres said another avenue for ER docs is small doses with very keen, close observation.
"If they tolerate that, then you can increase, because the obvious goal is to make them comfortable", said Squyres.
If the patient has a list of medicines they can produce - cardiac, pain, blood pressure, anything that could interact - that would help. And if there is an advocate, a son or daughter or neighbor, to take them to the ER who knows their meds and what the specific pain problem entails.
"This helps us tremendously", says Squyres.
The study found medical staff more concerned about finding a diagnosis rather than relieving pain.
Study authors say administering those medications can be beneficial to the patient, by preserving mobility and function. Good advice for "Your Health."