Discover and read the best of Twitter Threads about #PalliativeCare

Most recents (24)

1/🧵 A personal story of misjudgment as a physician.
 
Years ago, when I was a young doctor, I had a patient in the ICU on a ventilator who was doing so poorly, day after day, that I was certain he was going to die.

I confidently told the family he was going to die.
2/ The family members all gathered and were extremely distraught. They listened and trusted me.
 
But I was wrong.

#PalliativeCare #EndofLife
3/ For many years to come, I received Christmas cards from this man.

It was extremely humbling.
 
Until I learned, this happened many other times in my life as an ICU doctor.

Sometimes I was off by just 2 weeks, sometimes 2 months, and other times by 2 years.
Read 8 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
Read 60 tweets
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 #SRFclub hat die basalsten fragen nicht beantwortet? (musste abstellen. diese inszenierungen via betroffenheit - bei #SRFarena @SandroBrotz wie bei #SRFclub @BarbaraLuethi: scheint strategie @ploxa @brenntr zu sein - ist unerträglich.)

@PresseratCH @Mark_Eisenegger @ManuelPuppis
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 @SandroBrotz @BarbaraLuethi @PresseratCH @Mark_Eisenegger @ManuelPuppis @srg_d @srginsider @SRGSSR du meinst es ernst
mir ist langweilig

ich bin sozialarbeiter
dein kind ist authist

#FranziskaSprecher hat es ausgesprochen
@BarbaraLuethi hat sie abgeklemmt
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 @SandroBrotz @BarbaraLuethi @PresseratCH @Mark_Eisenegger @ManuelPuppis @srg_d @srginsider @SRGSSR ist die dir aufgefallen, dass die kommunikationsprofifrau, welche ihren kürzlich verstorbenen mann und ihre 10-jährige tochter tränenlos eingesetzt hat, ihren account mit #SchutzfaktorM führt? #blockalsammlung #SRFclub humanrights.ch/de/ueber-uns/o… woz.ch/-8275
Read 19 tweets
1/🧵 Why is COVID hospitalization like 2X sticks of dynamite 🧨?
 
A thread on the ICU portion… #PICS + #LongCOVID.
 
Prevent this w 3 steps:
📌Avoid #COVID by Vax & Mask
📌Avoid severe COVID by Paxlovid & Monoclonal Ab
📌👇 read here about PICS & how to reduce injury in the ICU
2/ Here’s what you must know if you get too sick & land in an ICU.

History Lesson 📝
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.

That’s happening again 🤮
3/ We kept patients immobilized due to an overly conservative approach to fall prevention that precluded us from attempting to walk them early. We kept families away from patients, treating loved ones as visitors rather than members of the healing plan.

That’s happening again.
Read 10 tweets
Künstliche Ernährung & Flüssigkeitszufuhr hat eine enorme medizinische, gesellschaftliche & natürlich ethische Brisanz. Viele haben sich bewusst dafür entschieden & können auch über Jahre damit gut & wohl auch mehr oder weniger zufrieden leben.
1/9
Gleichzeitig bekommt diese künstl. Ernährung in vielen Momenten & v.a. auch in d. letzten Lebensphase nochmal eine ganz neue Brisanz.
Es ist ganz oft mein Eindruck, d. hier viel Fehlinformationen & auch Ängste im Raum stehen, d. einfach viel zu selten angesprochen werden.
2/9
Dies mag einerseits daran liegen, dass man nicht gern über seine Ängste spricht. Andererseits ist das Sterben & der Tod bis heute in D ein großes Tabuthema, auch wenn es wohl in den vergangenen Jahren schon ein wenig besser geworden ist.
3/9
Read 9 tweets
Increasing overmedicalisation at the end of life is denying people & their families a good death.

Towards a compassionate community model: The Lancet #ValueofDeath Commission calls for a radical rethink of care for the dying & attitudes to death. hubs.li/Q0139HH30 Death and dying must be rec...
How death is managed today:
• Alienates communities
• Pushes families in countries without #UHC into poverty
• Deprioritises efforts to reduce suffering, such as #PalliativeCare
• Diverts resources
• Is costly for health services
#ValueofDeath hubs.li/Q013dcwv0 Image
Scientific advances have fuelled the belief death should be feared, avoided, defeated.

Centralising community involvement, partnerships, & better bereavement support will help rebalance societies' & medicine's relationship with death—an inevitable part of life. #ValueofDeath Image
Read 8 tweets
1/🧵 You’re dying in a hospital bed, and we grant you “THREE WISHES.” What would they be?

My dying patient is stunningly beautiful INSIDE & out. I asked what 3 wishes she had?

This video of the Birthday 🎂 party we had for her son is her BONUS Wish!

Read on for her share ❤️
Her Wish #1: Pizza, large w extra cheese. It’s been 3 years since she tasted SALT.

(again, all pics shown w their perm)
2/ Wish #2:

Expanded FAMILY visitation, which mean she enjoyed the ‘Za with all her children!

She said, “Dr. Wes, Dr. Koenig & @mad_ruk this is Priceless to me 🎁.”

Families are not a luxury. They are integral to healing (& healing can occur w/out cure).
Read 13 tweets
All the articles for the special issue of @PalliativeMedJ on "Big data for #PalliativeCare and End-of-Life Care Research" are now published!

Very happy to be a guest editor, together with Bregje Onwuteaka-Philipsen @amsterdamumc.

Let's see what's inside! [THREAD] 👇
1/ Editorial: The promise of big data for palliative and end-of-life care research

journals.sagepub.com/doi/full/10.11…
2/ Estimating the current and future prevalence of life-limiting conditions in children in England

The prevalence of children with a life-limiting condition has risen over the last 17 years and is predicted to increase in the future

journals.sagepub.com/doi/full/10.11… @lornafraser10
Read 11 tweets
Today is World Hospice and Palliative Care Day!

DYK❓ Over 5⃣5⃣ million people around the 🌐 are in need of #PalliativeCare but only 12% of the global need is met.

Access to palliative care services is a human right to health 👉bit.ly/3llLWSs
When life is threatened by serious illness such as

🚨 heart failure,
🚨 cancer,
🚨 chronic lung diseases,

#PalliativeCare offers comfort & solutions to improve physical and mental well-being of patients & their loved ones.

More info 👉bit.ly/WHOPalliativeC…
#PalliativeCare helps relieve suffering and improve quality of life for patients and families dealing with serious illnesses through

✅ practical help
✅ medicines
✅ spiritual and emotional support

More info 👉bit.ly/3ari8gJ
Read 12 tweets
To wrap up the final day of #21OPCC, here are ten key quotes that give an overview of topics discussed today.
“Cultural aspect of what death and dying mean. Other countries do that so much better than what we do in Australia.” - Prof Patsy Yates #21OPCC @pastyymates
"Aged care facilities want to provide great care - if funded appropriately, we can do that better, capacity can be built." - Peter Jenkin #21OPCC
Read 12 tweets
@PatsyYates and @didarmody in conversation at #21OPCC. #socialjustice is a major take away from this #palliativecare conference.
Importance of appreciating all unique contexts - homelessness, paediatric care, care of older people. Legal aspects of #palliativecare #21OPCC
International panel very strong on not "othering" - we can all learn from each other in a global community. COVID-19 has made that even clearer. Yes!! Well done international panel team. You rock :) @OdetteSpruyt @ntizimira @kpettus @APHPCN Dr Ghauri, Dr Malama #21OPCC
Read 9 tweets
Looking forward to following this podcast! Thanks @SammyWinemaker @HSeowPhD #21OPCC waitingroomrevolution.com
Ways to be prepared and hopeful facing serious illness. Walk 2 roads - hope for the best and prepare for the rest! Zoom out - understand the big picture. Know your style - find someone who meshes well with you. @HSeowPhD @SammyWinemaker #21OPCC
#palliativecare is not about planning for death, it's about planning for the future. We are more death-avoiding than death-denying. #21OPCC @HSeowPhD
Read 11 tweets
This morning’s plenary is given by Dr Hsien Seow @HSeowPhD, the recipient of the Ian Maddocks Guest Lecture, given to the best submission by an author under the age of 40 who is engaged in the study or delivery of #palliativecare #21OPCC
@meera_agar @Pall_Care_Aus chair provides history of Ian Maddocks Guest Lecture. Emritus Prof Maddocks was integral in establishing @Pall_Care_Aus #21OPCC
Dr Seow @HSeowPhD is the Canada Research Chair in #PalliativeCare #21OPCC
As part of his research, he created the Waiting Room Revolution PodCast @WaitingRoomRev
Read 31 tweets
Another full day of interesting and insightful discussions about #palliativecare at #21OPCC. Following are ten key quotes for an overview of the second full day of presentations.
"When the doctor has time to sit and listen, this has a huge impact on the patient" - Dr Diana Ferreira @diana_mbhf - great insight from the patients' perspective as a cancer patient #21OPCC
"Death is not linear" - Dr Katrin Gerber @NAgeingRI #21OPCC
Read 11 tweets
Last plenaries for the day about to begin - I'll be tweeting from this one- What is needed for better outcomes for breakthrough cancer pain? #21OPCC
Session chaired by Prof Gregory Crawford from Uni of Adelaide, Prof Andrew Davies from Trinity College, Dublin, Emeritus Prof Maree Smith from Uni of Qld, @diana_mbhf a #palliativecare researcher & cancer patient, & Dr Jessica Lee from Concord Centre for Palliative Care #21OPCC
Prof Andrew Davies - longstanding interest in breakthrough pain, disappointing thing is we still seem to have a problem in terms of diagnosing the problem, assessing it, and providing adequate medications #21OPCC
Read 14 tweets
I will now be tweeting from the ''Collaboration and Integration session, chaired by Camilla Rowland #21OPCC
First presenter in this session is Judy Hollingworth talking about 'Palliative care practitioners and community advocates collaborate in a disadvantaged rural region' #21OPCC
After a lovely acknowledgement to country, Judy begins her story about collaboration and causation #21OPCC
Read 76 tweets
Chaired by Dr Will Cairns OAM, introduces some of the early discussions about #palliativecare - identified key issues - continuity of care, caring for new patients with new conditions, caring for #COVID19 patients and also #palliativecare colleagues #21OPCC
Communication and international collaboration vital for management of #palliativecare during pandemic #21OPCC
Vital for #palliativecare providers to document their experiences of #COVID19 #21OPCC
Read 48 tweets
Welcome and acknowledgement to country by @didarmody
I acknowledge I am tweeting from Kaurna country and pay my respects to Elders past and present #21OPCC
.@didarmody reminds us to have a look at the art submitted for the art competition #21OPCC
International panel coming up! Incl #palliativecare experts @rachelcogs, Christian Ntizimira @ntizimira, Dr Katherine Pettus @kpettus, Dr Malama Tafuna’l from University of Otago, A/Prof Ghauri Aggarwal, and A/Prof @OdetteSpruyt #21OPCC
Read 47 tweets
Robert Yates of @ChathamHouse and @LSHTM comes to us from a sunny London! We are so lucky to have him chat to us about how palliative care can get a "decent crack of the whip" on universal health reforms. #21OPCC
@ChathamHouse @LSHTM "This is an opportunity for radical change. We should be prepared and get organised." But what is Universal Health Coverage? Important to nail down the definition. #21OPCC Simple definition here 👇 Image
@ChathamHouse @LSHTM But the longer definition makes it clear that palliative care is part of the continuum. Wherever you see UHC, we must insist on palliative care not being crowded out by curative services. #21OPCC Image
Read 18 tweets
The final session for Day 1 #21OPCC - How can #palliativecare get a 'decent crack of the whip' of Universal Health Reform? @ChathamHouse @yates_rob
Universal healthcare reform - #COVID19 could be an opportunity for great change #21OPCC
Defn of Universal Health Coverage = All people receive the quality health services they need without suffering financial hardship #21OPCC
Read 24 tweets
Changing gears from death law to death literacy. Tweeting now from @KezNoo workshop on using the death literacy index. #21OPCC
@KezNoo From care & social networks in 2008, to Death Literacy Index today, translated into multiple languages. A fantastic journey @KezNoo & team have been on linking networks with death literacy with public health with social determinants. #21OPCC @PHPalCare
@KezNoo @PHPalCare @DeathLiteracy definition. Talks about the "death system" which is important to think about in #compassionatecommunities. The death system is where all the partners converge - funeral directors, florists, churches, schools - all those existing outside the health system #21OPCC Image
Read 13 tweets
I'm tweeting now from the workshop on End of Life Law for Clinicians led by Prof Lindy Willmott
@QUT #21OPCC
@QUT Lots of relevant resources here: end-of-life.qut.edu.au #21OPCC
@QUT Exploring complex legal decision-making in #palliativecare. Are clinicians legally covered if they decide not to offer ongoing treatment deemed futile or worse, potentially harmful to the patient? #21OPCC
Read 17 tweets
Next, I’ll be tweeting from the 'Innovate and Change' session in the last concurrent session for Day #1 of #21OPCC, chaired by Shyla Mills
This a jam-packed session with discussions about innovation in palliative paramedicine, advance care planning and more #21OPCC
Serena Hoffman is about to start discussing "care at the end of life paramedic toolkit" #21OPCC
Read 50 tweets
I'm tweeting now from this workshop on Project Hamrahi. Come along and hear about the project, everything it has learnt, @ meet some of the team. #21OPCC oceanicpallcare.com/events/session… @AusPallLinkInt @OdetteSpruyt @rachelcogs
@AusPallLinkInt @OdetteSpruyt @rachelcogs Here is some more information and history about Project Hamrahi. Hamrahi is Hindi for "fellow traveller". A project of mutual learning and development between Australian/NZ and Indian palliative care providers, run by @AusPallLinkInt apli.net.au/project-hamrah… #21OPCC
@AusPallLinkInt @OdetteSpruyt @rachelcogs @OdetteSpruyt The project makes you think about the essence of palliative care, when resources are scarce. Compassion, holistic care. #21OPCC Image
Read 22 tweets

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