Rogers Ian R, Lukin Bill
Department of Emergency Medicine, St John of God Murdoch Hospital, Perth, Western Australia, Australia.
The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Emerg Med Australas. 2015 Dec;27(6):612-615. doi: 10.1111/1742-6723.12494. Epub 2015 Nov 11.
Only recently has the potential (unmet) palliative care (PC) workload in the ED been recognised. While confident in PC symptom management, we underestimate the role of a palliative approach in non-cancer diagnoses and seek education in areas such as individual patient care pathways, ethical and legal issues and difficult conversations at the end of life. PC is best introduced early for a range of life-limiting cancer and non-cancer diagnoses. Allowing patients time to tell their story with active listening, acknowledgement of suffering and a compassionate presence leads to treatment 'success' that is not defined by cure. This patient-centred, rather than disease-centred approach, is the essence of PC, and one that is easily incorporated into emergency practice. PC and disease-specific treatments can comfortably coexist, and with meticulous symptom management, may actually prolong life. PC is everyone's business, and emergency medicine needs to be part of it.
直到最近，急诊科潜在的（未得到满足的）姑息治疗（PC）工作量才得到认可。尽管我们对PC症状管理充满信心，但我们低估了姑息治疗方法在非癌症诊断中的作用，并在诸如个体患者护理路径、伦理和法律问题以及临终艰难对话等领域寻求教育。对于一系列限制生命的癌症和非癌症诊断，最好尽早引入PC。给予患者时间，通过积极倾听、承认痛苦和富有同情心的陪伴来讲述他们的故事，从而实现并非以治愈来定义的治疗“成功”。这种以患者为中心而非以疾病为中心的方法是PC的核心，也是一种很容易融入急诊实践的方法。PC和针对特定疾病的治疗可以和谐共存，并且通过精心的症状管理，实际上可能会延长生命。PC是每个人的职责所在，急诊医学需要成为其中的一部分。
