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0920 0945 shreves
This document discusses the need for more widespread palliative care. It notes that many patients currently receive poor end-of-life care in hospitals, with conversations about goals and prognosis often lacking or brief. While palliative care specialists could help, there is a severe shortage. The document argues that the solution is to train all clinicians, through fellowships, courses and online resources, to better address palliative care needs themselves since there will never be enough specialists to meet demand. All medical professionals must be prepared to provide palliative care.
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0920 0945 shreves
- 1. We Need PalliativeCare Everywhere SMACC DUB 2016 Ashley Shreves, MD Dept of Emergency Medicine Ochsner Medical Center New Orleans, LA
- 2. Case • 2009 • EMS:93 y/o f, resp distress • HR 25, BP 90/50, O2 sat 90%, RR 35
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- 5. Specific challenges • Identifydying trajectory • Capacity assessment • Advance directives • Difficult communication • Withholding/withdrawing LST • EOL symptom management • Spiritual competency • Ethics • Systems of care
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- 7. Conversations bad, briefor nonexistant Dying patients “neglected;” staff uncomfortable Dying in hospital: less respect, quality of care worse
- 8. WE ALL SUCKAT THIS
- 9. Relevant to you? Canada:1/3 cancer patients visit ED last 2 wks of life Australia: 65% patients w serious illness die in hospital/ED
- 10. WE ALL SEETHESE PATIENTS
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- 12. Consult Palliative Care? •Sure, but… • 67% US hospitals (50+ beds) have pal care • Workforce shortage: have 3K, need 18K (just in hospital) • There will never be enough Lupe D et al. J Pain Symptom Manage 2010 Dumanovsky T et al. J Palliate Med 2016 Kamal AH et al. Ann Intern Med 2015
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- 18. We need palliativecare everywhere