Palliative Care in Emergency Medicine

Applying some principles learned in Palliative Care to every-day Emergency Medicine practice – a guest post by Professor Ian Rogers FACEM, of St John of God Murdoch Hospital and University of Notre Dame in Perth, Western Australia Earlier this year I did a sabbatical in Palliative Care. I deliberately chose to work with a purely consultative service based in a tertiary teaching hospital. They did not admit under their own bed card nor was there a hospice on site to admit to. We saw patients from all across the hospital; from outpatients to ED, from ICU to slow stream rehabilitation. My aim was to gain an understanding of Palliative Care practiced in these acute settings and take some of the principles I learned back to Emergency Medicine. Most days in our own EDs we see patients with exacerbations of COPD. We can all picture a barrel chested man in his mid-70’s wheeled into the resuscitation bay with a nebuliser running. He is sitting bolt upright, intensely focussed on his next breath which will finish with a long expiratory wheeze just like the last. There isn’t much doubt that this is an exacerbation of his COPD just every other time he has presented. He can speak in short phrases at best, but no matter as you don’t really need to speak with him to know what to do. The medicine is easy; nebulised bronchodilators, steroids, some biPAP and perhaps some antibiotics. It worked last time so well that he got by with a few days in the respiratory HDU and didn’t need...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Palliative care Ian Rogers Prof Ian Rogers Source Type: blogs