Palliative Aspects of Emergency Care

Herausgeber: Desandre, Paul L.; Quest, Tammie E.

• Broschiertes Buch

Produktbeschreibung

Palliative Care in the Emergency Care is a practical guide for the care of patients with advanced illness who present to the emergency department.

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Produktdetails

• Verlag: Oxford University Press
• Seitenzahl: 154
• Erscheinungstermin: 1. Mai 2013
• Englisch
• Abmessung: 203mm x 127mm x 9mm
• Gewicht: 173g
• ISBN-13: 9780199895618
• ISBN-10: 0199895619
• Artikelnr.: 36898654

Autorenporträt

Assistant Professor, Department of Emergency Medicine and Center for Palliative Care; Associate Fellowship Director, Hospice and Palliative Medicine, Emory University School of Medicine, Atlanta, Georgia

Inhaltsangabe

Chapter 1: Overview
Chapter 2: Trajectories and Prognostication in Emergency Care
· Emergency Department and Functional Trajectories
· Prognostication and Prognostic Tools
o Cancer
o Heart Failure
o Chronic Obstructive Pulmonary Disease
o Dementia
· Communicating the Prognosis
· Creating a Plan of Action
Chapter 3: Rapid Palliative Care Assessment
· The Critically Ill or Unstable Patient
· The Medically Stable Patient
Chapter 4: Cancer Emergencies
· Spinal Cord Compression
o Pathophysiology
o Epidemiology
o Signs and Symptoms
o Diagnosis
o Interventions
§ Corticosteroids
§ Radiation Therapy
§ Surgery
§ Bisphosphonates
· Superior Vena Cava Syndrome
o Pathophysiology
o Etiology
o Signs and Symptoms
o Diagnosis
o Interventions
§ Radiation Therapy and Chemotherapy
§ Endovascular Stenting
o Prognosis
· Hypercalcemia of Malignancy
o Pathophysiology
o Interventions
Chapter 5: Malignant Pain
· The Cancer Pain Emergency
· The Emergent Pain Assessment
o Pain scales
o Classification
o Opioid naïve and opioid tolerant
· Pharmacologic Management
o Choosing an Algorithm
o Using Equianalgesic dosing tables
o Calculating the Initial Dose of an Opioid
o Advanced Age, Renal Impairment, and Hepatic Impairment
o Routes of Administration and Pharmacokinetics
o Pain Reassessment after Treatment
o Opioid Side Effects and Toxicities
§ Sedation and Respiratory Depression
§ Nausea and Vomiting
§ Myoclonus
§ Constipation
· Confrontation of Barriers
· Methadone
· Non-Opioid Pharmacologic Management
o Neuropathic Pain
o Bone Pain
o Other Approaches
Chapter 6: Non-malignant Pain
· Pain Pathophysiology
· Physiologic and Clinical Differences between Acute and Chronic Pain
· Definitions
o Tolerance
o Physical dependence
o Addiction
o Pseudoaddiction
· General Principles for Managing Chronic Pain
· Policies Informing Emergency Department Management of Chronic Pain
· An Emergency Department Approach to Managing Chronic Pain
Chapter 7: Symptom Management
· Dyspnea
o Pharmacologic approaches
§ Oxygen
§ Opioids
§ Anxiolytics
o Complementary and Non-Pharmacologic Approaches
· Delirium
· Anxiety
· Fatigue and Weakness
· Insomnia
· Fluid Balance and Edema
· Nausea and Vomiting
· Constipation
· Diarrhea
Chapter 8: Spiritual Suffering and Bereavement
· Definitions
· Grief: Normal and Complicated
· Spiritual Needs in the Emergency Department
o Role of the Clinician
o Role of the Chaplain
· Rapid Spiritual Assessment
· Responding to Hoping for a Miracle.
Chapter 9: Communication
· Breaking Bad News
· Death Disclosure
· Special Considerations
o Culture
o Requests to Withhold Information
o Telephone Notification
o No Next of Kin Available
o Communicating with Children
· Death of a Child
o Sudden Infant Death Syndrome
o Miscarriage or Stillbirth
· Self-Care and the Care of Other Emergency Department Staff
Chapter 10: Resuscitation, Family Presence, and Last Hours of Living
· Cardiopulmonary Resuscitation and Prognosis in Advanced Illness
· Family Presence During Resuscitation
· Witholding or Withdrawing Interventions
o CPR
o Intubation and Artificial Ventilation
o Artificial Nutrition and Hydration
o Antibiotics
· Care of the Actively Dying Patient
o Environment
o Symptom Control
o Secretions
o Dry Mouth
o Agitation
o Opioid Toxicity
Chapter 11: Hospice
· Understanding Hospice Care
o Eligibility
o Underutilization
o Scope of Services and Reimbursement
o Discontinuing Hospice Care
· Emergency Department Management of Patients under Hospice Care
· Common Presentations
· Initiating New Hospice Referrals from the Emergency Department
Chapter 12: Legal and Ethical Issues of Palliative Care in the Emergency Department
· The Interrelation of Law, Ethics, and End-of-Life Care
· Informed Consent
· Limitation of Treatment
· Determination of Decision-Making Capacity
· Decision-Making for the Incapacitated
· DNR Orders and Physician Orders for Life-Sustaining Treatments
· Opioids and End-of-Life Care
· Suicide and Physician-Assisted Suicide
· Futility