Managing Older Adults With Presumed COVID-19 in the Emergency Department

A Rational Approach to Rationing

Tony Rosen, MD MPH; Lauren E. Ferrante, MD MHS; Shan W. Liu, MD SD; Emily A. Benton, MD; Mary R. Mulcare, MD; Michael E. Stern, MD; Kevin Biese, MD; Ula Hwang, MD MPH; Martine Sanon, MD


J Am Geriatr Soc. 2020;68(8):1631-1635. 

In This Article

COVID-19 Care Decisions Made in the ED

The ED is often the first location where decisions about care for older adult patients with presumed or confirmed COVID-19 are made. These commonly include decisions about intubation and resuscitation after cardiac arrest. Geriatricians and other outpatient primary care providers have been managing patients at home, attempting to keep them out of the hospital unless absolutely necessary. Unfortunately, the course of COVID-19 is unpredictable, particularly for older adults, who may be managing well with the disease for several days and then acutely decompensate. Therefore, when patients arrive to the ED, the severity of their illness is often high, and they may already be in respiratory distress, requiring swift decision-making.