• C H Marck, J Weil, H Lane, T J Weiland, J Philip, M Boughey, and G A Jelinek.
• Emergency Practice Innovation Centre (EPIcentre), St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
• Intern Med J. 2014 Apr 1;44(4):362-8.

BackgroundPatients with cancer are presenting to emergency departments (ED) for end-of-life care with increasing frequency. Little is known about this experience for patients and ED clinicians in Australia.AimsTo assess the barriers and enablers regarding end-of-life care for cancer patients as perceived by Australian ED clinicians.MethodsThere were 4501 Australian ED clinicians invited through their professional colleges to complete an online survey, using multiple-choice and free-text responses.ResultsA total of 681 ED clinicians responded, most (84.2%) felt comfortable providing care to the dying and found it to be rewarding (70.9%). Although 83.8% found caring for the dying a reasonable demand on their role as clinician, 83.8% also agreed that the ED is not the right place to die. Respondents demonstrated a wide range of views regarding caring for this patient group in ED through free-text responses. In addition, 64.5% reported that futile treatment is frequently provided in the ED; the main reasons reported were that limitations of care were not clearly documented, or discussed with the patient or their family. Almost all (94.6%) agreed that advance care plans assist in caring for dying patients in the ED.ConclusionsOur findings provide important new insights into a growing area of care for ED. Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.© 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

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