Objectives for audience
1 Understand the principals of symptom assessment and ability to apply this to common symptoms
(eg. dyspnea, nausea & vomiting, constipation, delirium)
2 Management strategies for different symptoms
- Treatment of cause of the symptom
- Symptom palliation
Both can be applied at the same time.
3 Understand what constitutes palliative care emergencies in the context of symptom-control
4 Examples of palliative care emergencies (eg. Severe dyspnea, delirium) and how they are assessed and managed
1) Understand the principals of symptom assessment and ability to apply this to common symptoms
- Importance and significance of symptom assessment
- Using 1 symptom as an example, show how that symptom is assessed.
Suggest using symptom assessment acronym eg. OPQRSTUV
O nset
P recipitating/palliating factors
Q uality
R egion/radiation
S everity
T reatment
U nderstanding
V alues/goals
- Physical examination is included in the assessment
2) Management strategies for different symptoms
- Management of different symptoms in terms of treatment of the primary cause of symptom if possible and palliation of symptoms
3) Understand what constitutes palliative care emergencies
- Palliative care emergencies
– an unforeseen or sudden event that requires prompt assessment, evaluation, and management
– conditions that if untreated will seriously threaten the remaining quality of life and may also
affect the length of life
- Factors to consider in pall emergencies
- Nature of emergency, patient’s physical condition, disease status & likely prognosis, concomitant pathologies, symptoms, likely effectiveness vs side effects of proposed treatments, patient’s wishes, family’s wishes
4) Examples of palliative care emergencies and how they are assessed and managed.
- Suggest to use emergencies like dyspnea from SVCO, hemorrhage from head & neck tumor, seizures, pain from spinal cord compression/fractures.
- Can be done as case scenarios
- Illustrate how disease status and prognosis affects the management of that emergency
Eg. Spinal cord compression in patient with localized disease with long prognosis is managed differently from patient with extensive disease and short prognosis
References
1 Roberts D, McLeod B. Hospice Palliative Care Symptom Assessment Guide and Guideline for Use of the
Form. In: Fraser South Health Region, editor. 1st ed: Fraser South Health Region; 2004.
2 Caresearch, available https://www.caresearch.com.au/Caresearch/Default.aspx>
available April 20, 2017