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Capacity Building: Integration Of Palliative Care In Emergency Medicine

S. Lamba
Published 2016 · Medicine

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The emergency department (ED) cares for many seriously ill patients, including those with oncologic emergencies. In the seriously ill, ED visits tend to increase as the patient’s status deteriorates and as they approach the end of life. A collaborative approach between oncology, palliative care and emergency care providers has the potential to optimize patient care. This includes aligning patient and family goals with treatment plans and ensuring a smooth transition across care settings. Emergency medicine is increasingly taking a prominent role in integrating palliative care into emergency practice. For most seriously ill patients, their basic palliative care needs such as symptom control will likely be adequately met at the generalist level of palliative care provided by the ED providers. However, some patients with more complex issues and difficult-to-manage symptoms may need specialist level of palliative care delivered by providers with expertise and training in palliative medicine. This chapter outlines the role of ED palliative care in managing oncologic emergencies in the seriously ill patient. Initiatives such as the national Integrating Palliative Care into Emergency Medicine (IPAL-EM) project and other current models of ED palliative care integration are described. Finally, a stepwise approach to jump-start such an integration initiative is outlined for clinicians and administrators of programs that seek to optimize care for the seriously ill ED patient.
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