Education in palliative care principles for emergency department clinicians could likely improve care for seriously ill patients who present in the ED.
Many seriously ill patients rely on emergency department visits to address symptoms that could be alleviated or reduced with effective palliative care, including pain, digestive issues and shortness of breath, among others. However, clinical teams in the ED rarely receive training in comfort care or quality-of-life interventions, according to a recent study published in Cureus.
“Patients with serious illness, even hospice patients, present to the ED in increasing numbers for symptom management. It has become essential for emergency physicians to care for patients who are not seeking life-sustaining measures but instead need quality-of-life interventions,” the study indicated. “The development of a clear, concise review of the most common acute symptoms can provide a framework for EM physicians to adequately address the needs of patients.”
Populations who most need palliative care are often chronically ill seniors with complex health conditions. Between 2014 and 2017, these patients accounted for more than 20% of all emergency department (ED) visits in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC).
Research cited in the study indicated that residents in emergency management ranked pain and dyspnea management as important topics for a potential palliative care curriculum.
Most reported receiving little training in pain management or managing patients who need comfort care, and indicated that they saw a lack of structured, practical guidelines and education for emergency physicians on palliation.
“There is a growing recognition that initiating comfort care in the ED yields numerous advantages,” the study indicated. “The transition from curative to non-curative symptom management can be immediate. Emergency physicians need to skillfully adapt their care to respect the goals and values of the patients and their families.”