EM Vivas · Palliative and end-of-life care in ED
Palliative and end-of-life presentations in ED — Viva
Viva on symptom management at the end of life and communicating with family.
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ACEMFRCEMABEM
Prompt
A 78-year-old man with advanced COPD is brought in by family with worsening breathlessness. He has an advance care plan wishing not to be resuscitated or intubated.
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Viva Stems
- How do you identify that a patient should be on a palliative pathway? [4]
- List the four essential drugs for symptom management in the dying patient (OPCARE9). [1]
- Describe your approach to stopping futile treatment. [3]
- How do you care for the family during and after death in the ED? [2]
- What documentation is required around death in the ED? [2]
References4ShowHide
- [1]Lindqvist O, Lundquist G, Dickman A. Four essential drugs needed for quality care of the dying: a Delphi study J Palliat Med, 2013.PMID 23234300
- [2]Chua MT, Sen Kuan W, Zheng CQ, et al. Validation of Care of the Dying Evaluation in Emergency Medicine (CODE-EM) Ann Palliat Med, 2021.PMID 34118856
- [3]Kompanje EJ, van der Hoven B, Bakker J. Anticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of life Intensive Care Med, 2008.PMID 18516588
- [4]Theunissen M, Lardenoye S, et al. The surprise question: predictive accuracy in an unselected emergency department population - a prospective study in nurses and physicians. Ann Med, 2025.PMID 40665801