A narrative review on palliative care in the emergency department: dealing with the uncertainty of death

In the last decades emergency physicians have observed a steep increase in the emergency department (ED) admissions of palliative care patients who rely on the hospital for symptoms’ relief and management of acute exacerbations of their chronic disease. Previous studies have suggested that palliati...

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Main Authors: Lorenzo Porta, Eugenia Mauri
Format: Article
Language:English
Published: PAGEPress Publications 2023-06-01
Series:Emergency Care Journal
Subjects:
Online Access:https://www.pagepressjournals.org/index.php/ecj/article/view/11308
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author Lorenzo Porta
Eugenia Mauri
author_facet Lorenzo Porta
Eugenia Mauri
author_sort Lorenzo Porta
collection DOAJ
description In the last decades emergency physicians have observed a steep increase in the emergency department (ED) admissions of palliative care patients who rely on the hospital for symptoms’ relief and management of acute exacerbations of their chronic disease. Previous studies have suggested that palliative care interventions in the ED could prevent unnecessary admissions and reduce both the length of hospitalization and costs. However, emergency medicine physicians might have limited specialistic education and resources to provide a correct management of palliative care patients and avoid futile interventions. Thus, we aim in this narrative review to provide the reader with an introduction on the principles that should guide the emergency physician in a correct approach to palliative care patients in the ED. We will explain how to deal with the intrinsic prognostic uncertainty of palliative care patients by implementing a correct ethical approach which encompasses the understanding of both appropriateness and futility of intervention; furthermore, we will present practical tools such as scores and trials.
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spelling doaj.art-c7b3cd14c65a4fc5a16de98b47eb292d2023-06-23T22:51:20ZengPAGEPress PublicationsEmergency Care Journal2282-20542023-06-0119110.4081/ecj.2023.11308A narrative review on palliative care in the emergency department: dealing with the uncertainty of deathLorenzo Porta0Eugenia Mauri1School of Medicine and Surgery, University of Milano-Bicocca, Milan; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, MilanSchool of Medicine and Surgery, University of Milano-Bicocca, Milan; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan In the last decades emergency physicians have observed a steep increase in the emergency department (ED) admissions of palliative care patients who rely on the hospital for symptoms’ relief and management of acute exacerbations of their chronic disease. Previous studies have suggested that palliative care interventions in the ED could prevent unnecessary admissions and reduce both the length of hospitalization and costs. However, emergency medicine physicians might have limited specialistic education and resources to provide a correct management of palliative care patients and avoid futile interventions. Thus, we aim in this narrative review to provide the reader with an introduction on the principles that should guide the emergency physician in a correct approach to palliative care patients in the ED. We will explain how to deal with the intrinsic prognostic uncertainty of palliative care patients by implementing a correct ethical approach which encompasses the understanding of both appropriateness and futility of intervention; furthermore, we will present practical tools such as scores and trials. https://www.pagepressjournals.org/index.php/ecj/article/view/11308Palliative careemergency departmentdeathmedical ethicsappropriateness
spellingShingle Lorenzo Porta
Eugenia Mauri
A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
Emergency Care Journal
Palliative care
emergency department
death
medical ethics
appropriateness
title A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
title_full A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
title_fullStr A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
title_full_unstemmed A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
title_short A narrative review on palliative care in the emergency department: dealing with the uncertainty of death
title_sort narrative review on palliative care in the emergency department dealing with the uncertainty of death
topic Palliative care
emergency department
death
medical ethics
appropriateness
url https://www.pagepressjournals.org/index.php/ecj/article/view/11308
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