Dying patient Flashcards
1
Q
Gold standards framework for a dying patient
A
- identify
- Assess - current future clinical and personal needs
- Plan - ACP
2
Q
Symptoms of ‘death’?
A
Death rattle - 56% Urinary dysfunction - 53% Pain - 51% Restless aggitation- 42% Breathlessness - 22% N+V - 14% Sweating - 14% Jerking/twitching - 12% Confusion - 9%
3
Q
10 steps to breaking bad news
A
- Preparation
- What does the person already know
- Is more information wanted?
- Give a warning shot
- Allow denial
- Explain (if requested)
- Listen to concerns
- Encourage ventilation of emotions
- summarise and plan
- Offer availability
4
Q
Essential drugs for the dying
A
Analgesia - morphine/diamorphine
Anxiolytic - BZD (midazolam)
Antiemetic - metaclopramide, levomepromazine
Anti-secretory - hyoscine, butylbromide
5
Q
‘What shall we tell the children?’
A
Be honest, tell the truth
Factual information appropriate to age
Explain what death means
Children grieve - involve them and share their sadness
6
Q
Analgesic conversions:
Oral morphine –> S/c diamorphine
A
Divide total oral morphine dose by 3 = submit diamorphine
7
Q
Analgesic conversions:
Oral morphine –> Morphine sulphate
A
Divide total oral morphine dose by 2
