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Case Reports
Emergency Palliative Care: Patient With Cancer Diagnosis and Escalating Symptom Burden.
- Alexander Zirulnik, David Wang, and Jason K Bowman.
- Harvard Affiliated Emergency Medicine Residency, Massachusetts General Hospital and Brigham & Women's Hospital, Boston, Massachusetts, USA.
- J Palliat Med. 2024 Feb 1; 27 (2): 275278275-278.
AbstractIn this segment of the emergency department (ED) palliative care (PC) case series, we present a patient with advanced cancer not yet followed by PC or on hospice, who presents to the ED overnight with worsening nausea, vomiting, and acute on chronic abdominal pain. The ED team works to stabilize and treat the patient, reaches out to his oncologist, and seeks remote support and guidance from the on-call PC clinician. After a rapid "just-in-time" training, the ED clinician is able to have a focused goals-of-care conversation with the patient and his family and make person-centered recommendations. The patient is briefly admitted to the intensive care unit for ongoing medical optimization and symptom management, and then subsequently discharged home on hospice in alignment with his elucidated goals.
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