隨著台灣進入超高齡社會，高齡合併多重慢性疾病患者已成為急診主要就醫族群。此族群因生理儲備能力下降、多重用藥負荷及慢性疾病交互作用，形成高度脆弱性；當其暴露於急診壅塞、時間緊迫性與資訊斷層等系統壓力時，臨床風險呈現乘數放大效應，增加死亡率、再入院率、譫妄與用藥錯誤等不良結果。本文整合脆弱性累積理論、複雜適應系統理論與病人安全韌性觀點，提出「風險乘數—照護整合樞紐模型」，說明個體脆弱性與急診系統壓力交互作用之風險生成機制。並進一步論述專科護理師於風險整合節點之角色，透過動態風險評估、臨床藥物整合、譫妄評估與篩檢、結構化溝通及持續性生理監測等策略，調節風險放大效應，提升急診照護韌性。本文建議將高齡急診風險管理制度化，建立標準化流程與病人安全指標，以強化急診高齡照護之系統管理能力。

As Taiwan has entered a super-aged society, older adults with multimorbidity have become a major pa-tient population in emergency departments (EDs). Reduced physiological reserve, polypharmacy, and interactions among chronic conditions increase their vulnerability to adverse clinical outcomes. When individual vulnerability interacts with ED stressors—including crowding, time pressure, fragmented information, and workflow interruptions—clinical risks may be amplified rather than merely accu-mulated, thereby increasing the likelihood of mortality, hospital readmissions, delirium, medication errors, and other adverse outcomes. This article integrates the deficit accumulation model of frailty, complex adaptive systems theory, and resilient healthcare principles to propose the Risk Multiplier–Care Integration Hub Model. The model conceptualizes the dynamic interaction between patient vul-nerability and system-level stressors as a mechanism underlying risk amplification in emergency care. Within this framework, nurse practitioners (NPs) function as care integration hubs. Through dynamic risk assessment, medication reconciliation, delirium screening, structured interdisciplinary communi-cation, and continuous physiological monitoring, NPs may attenuate risk amplification, improve care coordination, and strengthen the resilience of emergency care systems. This article further advocates institutionalizing geriatric risk management in emergency care by implementing standardized clinical pathways and patient safety indicators. Such an approach may translate individual clinical expertise into sustainable organizational risk-management capacity, thereby improving the safety and quality of emergency care for older adults with multimorbidity.