It’s projected that by 2030, 1 in 5 Americans will be 65 or older, and the number of geriatric patients will only increase as medicine and science continue to advance and improve life expectancy.
As patients age, their bodies undergo many changes, meaning a more targeted approach to medical procedures, including airway management techniques, is required. Understanding these circumstances can make a vast difference in outcomes during emergencies.
Regardless of outward appearance, geriatric patients undergo many physiological changes that may make airway management more difficult. These include:
As with all patients, it’s important to gauge basic vitals and level of consciousness while preparing for treatment. However, there should be extra precautions taken with all geriatric patients, even if they appear to be in good overall health. Keep in mind that:
Considering the above factors, you must take special consideration and care when managing the airway of a geriatric patient, such as:
Additionally, due to the possibility of hypoxia progressing rapidly and the increased likelihood a geriatric patient takes medication that will mask physiological responses, a high index of suspicion should be maintained at all times.
Many older geriatric patients may have a history of cardiovascular disease or other medical conditions that increase in severity with age. In unhealthy or frail patients, it’s important to look for:
If any of these conditions are present, it’s recommended to use a supraglottic device to create a better seal for ventilation or video laryngoscopy (VL) when intubating to reduce the risk of harm to the patient.
Additionally, for many elderly patients – especially those who have lost integrity in their teeth and gums – suctioning should be avoided if possible as there is a heightened risk of causing a laceration. However, geriatric patients experiencing decreased tongue pressure will likely produce excess saliva. For these patients, it is recommended to use suction equipment, such as SSCOR’s reliable and effective EMS-designed products, before using a VL, as this will enhance visualization and reduce the risk of aspiration.
Managing the airway of geriatric patients presents many unique challenges, some of which may not be easily identifiable by outward appearance. However, by remaining vigilant, being knowledgeable of the health changes and challenges our older population faces, and having the proper equipment on hand, you can provide safe and effective care to the patient while minimizing the risk of complications.
Editor's Note: This blog was originally published in February, 2022. It has been re-published with additional up to date content.