Aggressive palliative care is just as important as aggressive critical care in the ED. Sometimes we will be the first physicians to talk to a family about end of life issues, even if their loved one is terminally ill. Now that is not how it should be, but it just means that we must be just as skilled at family palliative care discussions as we are at floating a transvenous pacer. In this podcast, I discuss my vision of how to handle palliative care issues in the ED.

Step I-Identify potential comfort care patients

Step II-Establish goals of care

Either aggressive curative or aggressive comfort. Sometimes, you will decide with the family to a "trial" of critical care

Step III-Sign the Paperwork

Step IV-Maximize comfort

start a fentanyl drip

consider glycopyrrolate or a scopolamine patch

Remember the concept of double effect

photo by P Nicholson

Updates:

Review-Palliative Care in the ED