• Andrew Wenger, Megan Potilechio, Kathryn Redinger, Joseph Billian, John Aguilar, and Josh Mastenbrook.
• Department of Palliative Care (A.W., M.P.), Northern Arizona Healthcare, Flagstaff, Arizona, USA; Department of Emergency Medicine (K.R., J.M.), Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA; Division of Epidemiology and Biostatistics (J.B.), Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA; Madison Emergency Physicians (J.A.), Madison, Wisconsin, USA.
• J Pain Symptom Manage. 2022 Aug 1; 64 (2): e71-e76.

ContextEMS providers frequently encounter patients in end-of-life situations. These situations can become ethically challenging depending on the nature of the event, availability of advance directives, and overall understanding of the situation by the patient and caregivers. This is particularly true for patients who are enrolled in Hospice, a specific form of end-of-life care available to patients with a terminal illness and expected lifespan of less than six months.ObjectivesThis study aimed to survey the state of Michigan's EMS providers regarding encounters with hospice patients to better understand challenges caring for this population and to identify any need for additional education.MethodsAn anonymous electronic survey was distributed via agency medical directors and a statewide listserv to all licensed EMS providers. Responses were collected via RedCap. Descriptive statistics were calculated.ResultsA total of 706 responses were received. Most responses were from paramedics (55%) or EMTs (34%). 96% indicated having at least one encounter with a hospice patient and 66% had greater than 10 encounters. Only 24% had received formal education on the care of hospice patients. A high percentage (86%) indicated interest in additional training in this area. Challenges identified among providers were inaccessible advance directives (72%), pressure from family for more aggressive treatment (61%), and difficulty contacting hospice personnel (48%).ConclusionEducational gaps may be narrowed with additional end-of-life specific curricular components, with EMS providers expressing a strong desire for such training.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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