'Palliating in the ER. Really?'

No conflicts

Palliative Care is Sexy

outline of super quick talk

• let's get on the same page...
• quick symptom pearls for everyday
• navigating difficult conversations effectively in the ED
• Q+A

Thanks for being a rural physician

Palliative Medicine is NOT care of the dying

Please leave Gravol alone

Try Zofran for your cholestatic itch but remember that it constipates

MALIGNANT BOWEL OBSTRUCTION BUNDLE
Octreotide 100mcg
Dex 10 mg
Ranitidine 50 mg
Haldol 0.5 mg and/or Maxeran 10 mg
Try to avoid NGT

FENTANYL FIRST?

Palliative ABCD

• A different approach to the critically ill patient with a palliative diagnosis
• Can provide a framework for dealing with crashing patients that may not benefit from escalation of care/critical care

a=advance directive?

b-make the patient feel better

c-caregiver consideration

D-decision making capacity?

DO EVERYTHING!

How do you make a recommendation?

patient-specific evaluation of options

• estimate the prognosis
• consider the treatments/burden of treatments
• form a values-based opinion

"Would it be helpful if I offered a recommendation?'

recap

• consider palliative care approach even when patient is not dying
• target your antinauseants
• ABCD your palliative emergencies
• don't be afraid to give a recommendation

QUESTIONS?