Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA.
Ann Palliat Med. 2022 Feb;11(2):936-946. doi: 10.21037/apm-20-2428. Epub 2021 Sep 15.
The purpose of this article is to discuss the goals of palliative care with regards to acute care surgery patients and review the literature regarding administration and implementation of palliative programs.
For patients who experience unexpected and sometimes catastrophic life changes related to trauma or emergency general surgery, palliative care is a crucial adjunct that can help ensure the provision of optimal symptom management, communication, and goal-concordant care provided.
Palliative care is medical specialty with a philosophy of care focused on improving the quality of life for patients with serious injury or illness and their loved ones. Palliative care provides significant benefit across the entire spectrum of illness and injury, regardless of prognosis. We will discuss palliative care topics related to trauma and emergency general surgery patients, including symptom management, goal setting, end of life care, communication strategies, addressing implicit/explicit bias, trauma-specific and emergency general surgery-specific considerations, and implementation strategies to reduce barriers for utilization of palliative care.
Unfortunately, palliative care is often underutilized in the trauma and emergency general surgery population. Acute care surgeons should be familiar with principles of primary palliative care, as well as understand the added benefits that be provided by consultant palliative care specialists.
本文旨在讨论急性外科手术患者的姑息治疗目标，并回顾姑息治疗计划的管理和实施方面的文献。
对于经历与创伤或急症普通外科相关的意外、有时甚至灾难性生命变化的患者来说，姑息治疗是一个重要的辅助手段，可以帮助确保提供最佳的症状管理、沟通和与目标一致的护理。
姑息治疗是一个医学专业，其护理理念侧重于改善严重受伤或患病患者及其家属的生活质量。姑息治疗在整个疾病和损伤谱中都有显著益处，无论预后如何。我们将讨论与创伤和急症普通外科患者相关的姑息治疗话题，包括症状管理、目标设定、临终关怀、沟通策略、解决隐含/显性偏见、创伤和急症普通外科特定考虑因素，以及减少姑息治疗利用障碍的实施策略。
不幸的是，姑息治疗在创伤和急症普通外科患者中常常未得到充分利用。急性外科医生应该熟悉初级姑息治疗的原则，并了解顾问姑息治疗专家可以提供的额外益处。
