Böhm Lennert, Schwartz Jacqueline, Michael Mark, Diehl-Wiesenecker Eva, Bernhard Michael, Neukirchen Martin
Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Arbeitsgruppe "Ethik" der Deutschen Gesellschaft für Interdisziplinäre Notfall- und Akutmedizin (DGINA e. V.), Berlin, Deutschland.
Anaesthesiologie. 2023 Dec;72(12):863-870. doi: 10.1007/s00101-023-01356-3. Epub 2023 Nov 23.
Patients with life-limiting or palliative illnesses represent a challenge for emergency departments because, despite the growing availability of specialized outpatient palliative care resources at home, patients often present during symptom exacerbations or when family caregivers become overwhelmed. Also, as life-limiting illnesses are frequently first diagnosed there and treatment goals are adjusted, it appears advantageous to establish early connections between emergency patients with palliative needs and palliative care resources. The objective of this study was to conduct a survey evaluating the availability of fundamental palliative care knowledge and palliative care structures in clinical acute and emergency medicine. For this purpose, an online survey was distributed via emergency medicine blogs, targeting physicians working in emergency departments. In total, 383 fully completed questionnaires were analyzed. It was found that the respondents often encounter patients with palliative needs. However, both outpatient and inpatient palliative resources are not universally accessible, and where, for instance, consultation services are available, there is a lack of consensus regarding the appropriate timing for their utilization. Structures for end of life care are largely in place, although time and personnel are often insufficiently available. There is an expressed interest in further education and training in palliative care. In conclusion, as emergency departments serve as the interface between outpatient and inpatient care, an interdisciplinary and holistic approach can be employed to lay the groundwork for ongoing palliative care, benefiting patients with palliative needs.
患有危及生命或需要姑息治疗的疾病的患者给急诊科带来了挑战,因为尽管国内专门的门诊姑息治疗资源越来越多,但患者往往在症状加重时或家庭护理人员不堪重负时前来就诊。此外,由于危及生命的疾病常常首先在急诊科被诊断出来,且治疗目标会有所调整,因此在有姑息治疗需求的急诊患者与姑息治疗资源之间尽早建立联系似乎很有好处。本研究的目的是进行一项调查,评估临床急性和急诊医学中基本姑息治疗知识和姑息治疗结构的可得性。为此,通过急诊医学博客分发了一项在线调查,目标受众是在急诊科工作的医生。总共分析了383份完整填写的问卷。结果发现,受访者经常遇到有姑息治疗需求的患者。然而,门诊和住院姑息治疗资源并非普遍可得,例如,在有咨询服务的地方,对于其使用的适当时间缺乏共识。临终关怀结构基本到位,尽管时间和人员往往不足。人们对姑息治疗的进一步教育和培训表达了兴趣。总之,由于急诊科是门诊和住院护理之间的接口,可以采用跨学科和整体的方法为持续的姑息治疗奠定基础,使有姑息治疗需求的患者受益。