COMMENTARY

Palliative Care in Sudden Death

Betty R. Ferrell, PhD, RN

Disclosures

July 06, 2016

Palliative Care and Sudden Death

Palliative care can play an important role in cases of sudden death. Although palliative care is most often associated with chronic illnesses, much can be done in supporting the family in sudden illness and death. Even though the ED is very busy, as in this case, Joan should be honestly informed about her husband's death as soon as possible. Bereavement follow-up is important in sudden deaths, but palliative care can also provide support at the time of death.

Many deaths occur before patients' arrival in the ED or soon thereafter. Whether from automobile accidents, other trauma, or acute illness events, these sudden deaths can be difficult to manage amidst the busy environment of the ED and by professionals unfamiliar to the family. Palliative care teams can be very supportive in the case of sudden death in the ED to assist the ED staff in giving news of the death, explaining what has happened, assessing the family members' immediate coping and physical needs, and in making decisions about care and transition of the body.[1,2,3] Palliative care teams also can assist with notifying family members of the death by telephone or as they arrive at the ED.[4]

There are several models of palliative care integration in the ED and in cases of sudden death.[5,6] These teams have developed recommendations for aspects of sudden death, including telephone notification, which can be extremely difficult when death occurs suddenly.

The palliative care team can also provide support for the ED staff, who are often overwhelmed by sudden deaths, failed efforts at resuscitation, trauma care, victims of crime, and the increasing population of vulnerable, complex patients accessing the ED as their only source for chronic care.

Most palliative care teams are extremely busy meeting the needs throughout the hospital, so it is not possible to have dedicated palliative care staff for the ED. However, having access to palliative care services as needed can be valuable for the ED staff. There is growing literature[1,2] about ways to best use palliative care services in the ED.

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