the OLD PERSON WORKUP

Is it my imagination or are old people multiplying? I swear half of our patients (if not more) are 80 and above these days. Its like an old people parade every day.

What are the most common complaint for those old hats among us? Weakness. Dizziness. Near syncope. In other words who the hell knows what is wrong with them. Maybe they are just old for cripes sake. Maybe you just feel weak and dizzy when you are that old and feel like fainting occasionally.

Old people seem to come in 3 categories: 1) the nice people who have kept their wits about them 2) the demented 3) the nervous Nellies.

I love the people who are nice of course. They are the type of person who hates bothering us. They are a delight. The demented are really okay too, except if they are mean or are yellers. Yellers are can drive you to drink after work. The nervous Nellies are the worst. They are 99.9% women. Why is it when women get old they seem to become nervous twits? Seriously. They drive you nuts. Usually nervous Nellies are accompanied by Overly Involved and Neurotic Daughter who appear at the room door q5" asking for something.

There is no telling what is wrong with weak, dizzy, near syncopal Ned/Nellie, of course, so they get the $10,000 OLD PERSON WORKUP. They get a CBC, Lytes, Troponin, UA, CXR, EKG, head CT. They are put on the monitor, usually have to start an IV. Often times have to be cathed. Nellie usually has to get on the commode q15".

In other words they are a whole helluva lot of work. If half the ER is full of Ned/Nellies, you run your butt off. Pretty soon, in the next 10 years, 90% of ER patients will be over 70. Then what?