November 21, 2022

Palliative Care in the ED

Dr. Grudzen discusses specialty, and hospice palliative care in the ED. Dr. Grudzen is an emergency physician who is passionate about caring for patients with serious illness, such as cancer.

“This MicroED video was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number 1 NU50CK000570). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.”

Faculty: Corita Grudzen, MD, MSHS, FACEP

  • Corita R. Grudzen, MD, MSHS, FACEP
  • Professor, Emergency Medicine and Population Health
  • Associate Dean, Clinical Sciences
  • Deputy Director, Clinical and Translational Science Institute
  • Vice Chair for Research, Emergency Medicine
  • Ronald O. Perelman Department of Emergency Medicine
  • NYU Grossman School of Medicine

Read Video Transcript

- Welcome to MicroED, quick facts for big issues. My name's Corita Grudzen, and I'm an emergency physician. Here are some tips about how to use palliative care in the ED. ED visits for older adults with serious life-limiting illness continue to grow. Many prefer to receive care at home and avoid life-sustaining therapies. Hospice and palliative medicine is a subspecialty that's been shown to decrease symptom burden, increase patient and family satisfaction, and improve quality of life. However, teams are limited in number, and they're consulted far too late. Primary palliative care is provided by generalists and can and should be delivered by emergency physicians. Assessing for advanced directives is vital to ensure care that's concordant with patients' previous wishes. Hospice care, usually delivered at home, focuses on relief of burdensome symptoms and caregiver support. Hospice patients may arrive in the ED for many reasons that deserve careful inquiry and communication with the hospice team. In the ED, primary palliative care includes assessing for the presence of advanced directives, inquiring about hospice and communicating directly with the agency, and aggressively treating burdensome symptoms. Specialty palliative care in the ED, usually in the form of consultation from an inpatient team, should be considered for unclear goals of care or family conflict, discharge planning for patients actively dying or whose goals are consistent with hospice care. Thank you for listening, and we hope this improves your practice.

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