Palliative Care Flashcards
What information might an out of hours (OOH) doctor handover form for a palliative patient contain? (11 items total)
- Patient demographics and contact details of their carers and usual GP
- Main diagnosis and other relevant issues
- Allergies and Reactions
- Current medications - syringe driver available?
- Patient and carers understanding of their condition
- Any special advice the OOH should be aware of
- Agreed care plan
- Preferred place of care
- Whether the GP can be contacted out of hours
- Resus status
- Will the usual GP be okay to sign the death certificate?
What is a useful question to ask yourself when deciding if a patient should be classed as palliative?
Would I be surprised if this patient passed away in the next 6-12 months? if no, then maybe they should be considered end of life
What percentage of each practices population pass away annually?
1%
When are patients classed as ‘approaching end of life’?
When they are likely to die within the next 12 months, including those patients whose death is imminent.
Which patients commonly are classed as end of life (EOL)?
- Those with advanced, progressive, incurable conditions
- General frailty and co-existing conditions that mean they are likely to die within the next 12 months
- Existing conditions if they are at risk of ding from a sudden acute crisis in their condition
- Life-threatening acute conditions caused by sudden catastrophic events
What is an ‘advanced decision’?
A legally binding document that sets out a patients’ care wishes for the future. This allows their wishes to be followed, even if it comes to a time where the patient cannot communicate how they wish their care to be carried out.
Outline the steps for confirming a death (9 steps)
- Wash hands
- Confirm the patients’ identity (if they’re unknown to you)
- Inspect for any signs of life - respiration or response to verbal stimuli
- Pressure on finger or supraorbital notch or a sternal rub
- Check pupils to ensure fixed and dilated pupil
- Feel for carotid pulse for at least 2 minutes
- Listen for heart sounds for at least 2 minutes
- Listen for respiratory sounds for at least 3 minutes
- Wash hands, document findings and record the time of death as you have confirmed it
What medication can we give to control the following palliative care symptom: anorexia?
Prednisolone
Dexamethasone
What medication can we give to control the following palliative care symptom: Bowel colic and excessive respiratory secretions?
Subcutaneous hycosine hydrobromide, hycosine butylbromide or glycopyrronium bromide (all antimuscarinics)
What medication can we give to control the following palliative care symptom: capillary bleeding?
Tranexamic acid
Vitamin K
What medication can we give to control the following palliative care symptom: constipation?
Lactulose
Senna
What medication can we give to control the following palliative care symptom: convulsions?
Phenytoin
Carbemazepine
Diazepam
Phenobarbital
What medication can we give to control the following palliative care symptom: dry mouth?
Good mouth care
If candidaisis? Nystatin
What medication can we give to control the following palliative care symptom: dysphagia?
Dexamethasone
What medication can we give to control the following palliative care symptom: dyspnoea?
Morphine
Diazepam
