Engel Kirsten G, Quest Tammie E
Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Division of Palliative Medicine, Department of Family and Preventive Medicine, Emory University Hospital, Atlanta, Georgia, USA.
J Palliat Med. 2024 Jan;27(1):139-142. doi: 10.1089/jpm.2023.0188. Epub 2023 Oct 20.
In this first segment of the emergency palliative care case series, we present a patient who arrives to the emergency department (ED) with signs of impending death in the setting of a newly diagnosed nonsurvivable condition. The patient has a history of chronic and serious illness including metastatic lung cancer, but her ED presentation is prompted by new symptoms of abdominal pain and diarrhea that are not immediately attributable to her known history and reflect the onset of a catastrophic process. Palliative care consultation is requested after surgery determines that that patient is not a candidate for surgical intervention. The palliative care provider plays an important role in supporting aggressive symptom management, elucidating goals of care, and rapidly facilitating disposition.
在这个急诊姑息治疗病例系列的第一部分中，我们介绍了一名患者，她因新诊断出的无法治愈的疾病而出现濒死迹象，被送往急诊科（ED）。该患者有包括转移性肺癌在内的慢性重症病史，但她在急诊科的表现是由腹痛和腹泻等新症状引起的，这些症状不能立即归因于她已知的病史，而是反映了一个灾难性过程的开始。在手术确定该患者不适合手术干预后，请求了姑息治疗会诊。姑息治疗提供者在支持积极的症状管理、阐明护理目标以及迅速促进处置方面发挥着重要作用。
