Welche Entscheidungs- und Beurteilungshilfen können Notfallsanitäter:innen beim prähospitalen geriatrischen Einsatz unterstützen?

Emergency paramedics, emergency nurses and emergency physicians must constantly adapt to new challenges in the daily provision of care. The initial assessment of elderly patients can be challenging due to communication barriers, limited diagnostic options and available information regarding polypharmacy and multimorbidity.

The aim of this study is to provide practical suggestions for the assessment of geriatric patients by emergency medical service personnel.

Geriatric symptoms are diverse. Delirium is a common and sometimes serious threat that can make assessments more difficult. The acronyms “KEIM” (Cardiac events, Electrolyte imbalance, Infection, Medication) and GEMS (Geriatric Patient, Impressions of the Environment, Medical Assessment, Social Assessment) are to be understood as auxiliary letters in the initial assessment of geriatric patients. With ISAR (Identification of Seniors at Risk) screening and other screening instruments, such as the 4A (Alertness, Abbreviated Mental Test, Attention, Acute Change or Fluctuating Course) test, 6CIT (Six Item Cognitive Impairment Test), or Ottawa 3DY (date, day, dlrow [spelling “world” backwards], year) test, specific tools are available for risk assessment.

KEIM, GEMS and ISAR screening, as an extension of X‑ABCDE (Exsanguination, Airway, Breathing, Circulation, Disability, Exposure), are helpful in the assessment of geriatric patients outside the hospital and should be supplemented by the 4A test for delirium screening as required. These aspects should be addressed in the training and further education of healthcare professionals. It is desirable to be able to use digital assessment and screening instruments.