Designing Prehospital Care that is Optimized for Older Adult Patients: A Critical Opportunity to Reduce Harm

Older adults represent a large and increasing fraction of 9-1-1 calls requiring emergency medical services (EMS) response. This population differs substantially from younger adults due to physiologic changes, cognitive impairment and behavioral disturbance, atypical presentation of disease, frailty, functional limitations, the impact of comorbid conditions, and the effects of polypharmacy. Not considering these when providing prehospital care is common and may lead to substantial harm for older adult patients. We therefore, recommend that EMS professionals consider system changes in education, protocol development, and quality improvement to improve care. Research gaps in optimal geriatric prehospital care should be identified and closed. The movement to improve care for older adults in emergency departments offers a model for how to effectively do so in the prehospital setting.