Initiating palliative care in the emergency department.

BACKGROUND

In 2006, nearly a quarter of a million patients either arrived dead or died in the Emergency Department (ED). The role of palliative care (PC) in the ED is not well defined, and education of medical students and residents in the area is sparse.

OBJECTIVES

We use an illustrative case to discuss important concepts in PC for the emergency physician (EP). The reader should be able to define hospice and PC, recognize its importance in the practice of Emergency Medicine, and understand the benefits PC has for the patient, the patient's family and caregivers, and the health care system as a whole.

DISCUSSION

PC excels at treating pain and addressing end-of-life issues. Families and caregivers of patients benefit from PC in terms of improved personal quality of life after the patient's death. PC is more cost-effective than traditional medical care.

CONCLUSION

Research on PC in the ED is sparse but it is a growing need, and the EP will need to become proficient in the delivery of PC in the ED.