End Of Life Care

Question 1

Clinical features of close to dying?

Answer 1

Delirious/confusion
Less eating/drinking
More sleeping
Respiratory changes
Cold peripheries

Question 2

Symptom Management

Answer 2

Analgesia
Nausea
Agitation
Secretion
Bowel Care

Question 3

Ceasing unnecessary interventions?

Answer 3

Cease obs
Fluid balance
BSLs

Question 4

TOO MUCH MORPHINE!

Answer 4

Not to hasten, to make them comfortable
Can be sleepy normally when around dying
Trade off. Morphine but sleepy, or awake but in pain.

Question 5

Uncertainty of dying, how long? And when should family come in?

Answer 5

If is important to see them, the sooner the better.

Question 6

When referring to Pall care, keep in mind:

Answer 6

Medical history
The lead up.
The family’s understanding

Question 7

After Death Procedures

Answer 7

Confirming: ritual/religious issues/brutal times
Coroner’s: electronic, need for senior assistance
Certifying: electronic link

Question 8

Certification of Death

Answer 8

Reportable? (Mostly known before they die)

Question 9

Types of reportable deaths?

Answer 9

Unnatural: accidents or injuries
Unexpected, violent
During a medical procedure
Held in custody or care
Residential care
Unable to sign why 
Identify unknown

Question 10

Commonly missed reportable

Answer 10

Due to accident
Detained by state
Falls/fractures
Arrest out of hospital where investigations did not find a cause

Question 11

Death Certificates

Answer 11

• Must have seen the patient in life or death to do certificate
• if don’t know well, read notes and check with senior
• need AHPRA rego number
• cause of death: the underlying cause, not a process
• malignant: cell type, site & duration