Articles: palliative-care.
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Emerg. Med. Clin. North Am. · May 2021
ReviewClinical Relevance and Considerations of Palliative Care in Older Adults.
The incorporation of palliative care to address the needs of the older adult is a vital part of emergency medicine. Recognizing the trajectory of chronic diseases in older adults and the myriad of medical diseases amenable to palliative care is paramount. Early involvement of palliative care should be considered the cornerstone to overarching management of the older adult presenting to the emergency department.
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J Pain Symptom Manage · May 2021
ReviewDo the clinical management guidelines for Covid-19 in African Countries reflect the African quality palliative care standards? A review of current guidelines.
Palliative care should be a component of COVID-19 management to relieve suffering, improve patient outcomes and save cost. ⋯ Comprehensive palliative care which addresses physical, psychological, social and spiritual concerns must be prioritized within case management guidelines in African countries.
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Pediatr Crit Care Me · May 2021
Variation in Pediatric Palliative Care Allocation Among Critically Ill Children in the United States.
The objectives are as follows: 1) estimate palliative care consult rates and trends among critically ill children and 2) characterize which children receive palliative care consults, including those meeting previously proposed ICU-specific palliative care screening criteria. ⋯ Palliative care consultation for critically ill children in the United States is low. Palliative care utilization is increasing but considerable variation exists across institutions, suggesting inequity in palliative care allocation among this vulnerable population. Future studies should evaluate factors influencing allocation of palliative care among critically ill children in the United States and the drivers of differences between the institutional practices.
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Case Reports
Palliative Spine Surgery in a Patient with Advanced Cancer: A Case Report and Decision-Making Guide.
The spine is a frequent site of cancer metastasis leading to intractable pain, functional impairment, and poor quality of life. When analgesic regimens and nonpharmacological interventions fail, spine surgery may be indicated. For patients with advanced disease, the decision to operate can become a dilemma. ⋯ Shortly after surgery, he settled on a regimen merely equivalent to 45 mg of morphine per day. The article explores the role of palliative spine surgery in managing intractable cancer-related back pain. The authors offer a guide when considering surgical procedures for patients with limited prognosis.
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Background: Standardized referral criteria can aid in identifying patients who would benefit from palliative care consultation. Little is known, however, on palliative care team members' perceptions of these criteria. Objective: Describe palliative care programs' reasons for referral criteria implementation and their perception of the benefits or disadvantages of its use. ⋯ Late referrals (64.2%) were the most commonly cited reason for referral criteria implementation. The majority (77.4%) felt that referral criteria lead to positive outcomes, including earlier referrals for palliative care-appropriate patients (71.7%). Increases in staff workload and inappropriate referrals were identified as disadvantages of referral criteria use.* Conclusion: Palliative care program members identified both benefits and disadvantages of referral criteria use, but felt they had mostly productive results. *Correction added on March 18, 2021 after first online publication of December 18, 2020: In the Results section of the abstract, the third sentence was changed from "Increases in clinical volume and inappropriate referrals were identified as disadvantages of referral criteria use." to "Increases in staff workload and inappropriate referrals were identified as disadvantages of referral criteria use."