Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Emergency, Harvard Medical School, Boston, Massachusetts, USA.
J Palliat Med. 2024 Mar;27(3):430-433. doi: 10.1089/jpm.2023.0258. Epub 2023 Oct 20.
In this segment of the emergency department (ED) palliative care case series, we present a patient who arrives to the ED after a fall resulting in a hip fracture. He is also found to have hypernatremia and an acute kidney injury and develops delirium while in the ED awaiting an inpatient bed. The ED-based integrated geriatric palliative care program is consulted and performs a multidimensional assessment. The geriatric palliative care clinician facilitates discussion with his daughter about surgical intervention based on the patient's goals and values, diagnoses delirium, and worsening depression, creates a plan for delirium and pain management, and accelerates postdischarge planning.
在这段急诊科（ED）姑息治疗病例系列中，我们介绍了一位因跌倒导致髋部骨折后到达 ED 的患者。他还被发现患有高钠血症和急性肾损伤，并在 ED 等待住院床位时出现谵妄。ED 综合老年姑息治疗项目被咨询，并进行了多维评估。老年姑息治疗临床医生与他的女儿就基于患者目标和价值观的手术干预进行了讨论，诊断出谵妄和抑郁恶化，并制定了谵妄和疼痛管理计划，并加速了出院后计划。
