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Hello @Me4Trauma and @me4_so. Welcome to my tweetorial on Palliative Care for the trauma patient.
To start, palliative care as defined by @WHO. Palliative care is often delivered along side disease modifying treatment.
@Surgpallcare #SoMe4Trauma #SoMe4Surgery
Hello @Me4Trauma and @me4_so. Welcome to my tweetorial on Palliative Care for the trauma patient.
To start, palliative care as defined by @WHO. Palliative care is often delivered along side disease modifying treatment.
@Surgpallcare #SoMe4Trauma #SoMe4Surgery
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What is Surgical Palliative Care? As defined by Dr. Geoffrey Dunn, it is "interdisciplinary care whose goal is to relieve suffering and improve quality of life of the surgical patient and their family." More info here:
ncbi.nlm.nih.gov/pubmed/21419251
#SoMe4Trauma #SoMe4Surgery
What is Surgical Palliative Care? As defined by Dr. Geoffrey Dunn, it is "interdisciplinary care whose goal is to relieve suffering and improve quality of life of the surgical patient and their family." More info here:
ncbi.nlm.nih.gov/pubmed/21419251
#SoMe4Trauma #SoMe4Surgery
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While the practice of Surgical Palliative Care may include palliative procedures (venting G tubes, intestinal bypass, etc) it definitely includes family meetings, goals of care & code status discussions, prognostication & skilled symptom management. #SoMe4Trauma #SoMe4Surgery
While the practice of Surgical Palliative Care may include palliative procedures (venting G tubes, intestinal bypass, etc) it definitely includes family meetings, goals of care & code status discussions, prognostication & skilled symptom management. #SoMe4Trauma #SoMe4Surgery
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The term Palliative Care was coined by Canadian urologist, Dr. Balfour Mount, known as the Father of Palliative Care in North America and pictured below with Dame Cicely Saunders, the founder of the modern hospice movement. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/dr-…
The term Palliative Care was coined by Canadian urologist, Dr. Balfour Mount, known as the Father of Palliative Care in North America and pictured below with Dame Cicely Saunders, the founder of the modern hospice movement. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/dr-…
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Established in 1996, @RWJF Promoting Excellence in End-of-Life Care resulted in multiple papers including this by @AnneMosenthalMD and Pat Murphy, RN- the first to outline the role of Palliative Care in trauma, for patient & family. #SoMe4Trauma #SoMe4Surgery
Established in 1996, @RWJF Promoting Excellence in End-of-Life Care resulted in multiple papers including this by @AnneMosenthalMD and Pat Murphy, RN- the first to outline the role of Palliative Care in trauma, for patient & family. #SoMe4Trauma #SoMe4Surgery
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In it, the authors argue that Palliative Care should be integrated into trauma because:
-it can lead to marked change in function
-it can happen to old folk with multiple issues and various goals of care
-families of pt who die suddenly need support
#SoMe4Trauma #SoMe4Surgery
In it, the authors argue that Palliative Care should be integrated into trauma because:
-it can lead to marked change in function
-it can happen to old folk with multiple issues and various goals of care
-families of pt who die suddenly need support
#SoMe4Trauma #SoMe4Surgery
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This was followed by another paper which described the integration of Palliative Care into the Trauma ICU and Surgical ICU through a 6 step process. ncbi.nlm.nih.gov/pubmed/17057605
This was followed by another paper which described the integration of Palliative Care into the Trauma ICU and Surgical ICU through a 6 step process. ncbi.nlm.nih.gov/pubmed/17057605
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1. Grief support for families
2. Palliative Care assessment in 24 hr
3. Family meeting in 72 hr
4. Palliative Care plan in 72 hr
5. Palliative Care order set for the imminently dying
6. Integration of Palliative Care performance measures into M & M. #SoMe4Trauma #SoMe4Surgery
1. Grief support for families
2. Palliative Care assessment in 24 hr
3. Family meeting in 72 hr
4. Palliative Care plan in 72 hr
5. Palliative Care order set for the imminently dying
6. Integration of Palliative Care performance measures into M & M. #SoMe4Trauma #SoMe4Surgery
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3rd paper reviewed results of structured pall care intervention integrated into ICU:
-earlier consensus around goals of care
-no change in rates of mortality, DNR orders or withdrawal of life support
-earlier DNR and withdrawal
-decreased ICU LOS #SoMe4Trauma #SoMe4Surgery
3rd paper reviewed results of structured pall care intervention integrated into ICU:
-earlier consensus around goals of care
-no change in rates of mortality, DNR orders or withdrawal of life support
-earlier DNR and withdrawal
-decreased ICU LOS #SoMe4Trauma #SoMe4Surgery
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In 2005, the @AmCollSurgeons published its Statement on the Principles of Surgical Palliative Care. Since 2008, @AmBdSurg has co-sponsored the certification exam for Hospice and Palliative medicine (80 surgeons are currently certified) #SoMe4Trauma #SoMe4Surgery
In 2005, the @AmCollSurgeons published its Statement on the Principles of Surgical Palliative Care. Since 2008, @AmBdSurg has co-sponsored the certification exam for Hospice and Palliative medicine (80 surgeons are currently certified) #SoMe4Trauma #SoMe4Surgery
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Pall care is particularly useful for geriatric pts. Folks > 65 account for 20% of all hospital related trauma admissions. @Emily62262871 @pferrada1 et al did a 1 yr retrospective review @VCUHealth. Only 82 pts were seen by pall care team, most in last 24 hours of life.
Pall care is particularly useful for geriatric pts. Folks > 65 account for 20% of all hospital related trauma admissions. @Emily62262871 @pferrada1 et al did a 1 yr retrospective review @VCUHealth. Only 82 pts were seen by pall care team, most in last 24 hours of life.
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@traumadoctors @EAST_TRAUMA reported that "early pall care consultation was associated with improved secondary outcomes such as length of stay." There is room for improvement to consult pall care earlier! #SoMe4Trauma #SoMe4Surgery
@traumadoctors @EAST_TRAUMA reported that "early pall care consultation was associated with improved secondary outcomes such as length of stay." There is room for improvement to consult pall care earlier! #SoMe4Trauma #SoMe4Surgery
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@AmCollSurgeons @ACSTrauma published Palliative Care Best Practice Guidelines:
-deliver pall care in parallel with life-sustaining trauma care
-the unit of care is the patient & family
-core trauma pall care can be provided by trauma team #SoMe4Trauma #SoMe4Surgery
@AmCollSurgeons @ACSTrauma published Palliative Care Best Practice Guidelines:
-deliver pall care in parallel with life-sustaining trauma care
-the unit of care is the patient & family
-core trauma pall care can be provided by trauma team #SoMe4Trauma #SoMe4Surgery
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-Optimal pall care requires an interdisciplinary team (doctors, nurses, LCSWs, chaplain, rehab providers)
-Trauma physicians must have basic competencies in primary palliative care skills #SoMe4Trauma #SoMe4Surgery
facs.org/-/media/files/…
-Optimal pall care requires an interdisciplinary team (doctors, nurses, LCSWs, chaplain, rehab providers)
-Trauma physicians must have basic competencies in primary palliative care skills #SoMe4Trauma #SoMe4Surgery
facs.org/-/media/files/…
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Drs. Kathleen O'Connell and Ronald Maier @harborviewmc @UWSurgery wrote that Palliative Care should be considered as the fourth pillar of acute care surgery and that Palliative Care should be integrated into surgical resident education.
#SoMe4Trauma #SoMe4Surgery
Drs. Kathleen O'Connell and Ronald Maier @harborviewmc @UWSurgery wrote that Palliative Care should be considered as the fourth pillar of acute care surgery and that Palliative Care should be integrated into surgical resident education.
#SoMe4Trauma #SoMe4Surgery
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What about hospice? Hospice is interdisciplinary care meant specifically for folks who have SIX months or less to leave AND who no longer want to pursue curative care. Hospice is a philosophy of care, rather than a place of care.
#SoMe4Trauma #SoMe4Surgery
What about hospice? Hospice is interdisciplinary care meant specifically for folks who have SIX months or less to leave AND who no longer want to pursue curative care. Hospice is a philosophy of care, rather than a place of care.
#SoMe4Trauma #SoMe4Surgery
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The majority of hospice pts receive care in their home, but it can be a huge burden on family. Working closely with palliative care team & case management will help you understand options available depending on payor source. Don't overpromise! #SoMe4Trauma #SoMe4Surgery
The majority of hospice pts receive care in their home, but it can be a huge burden on family. Working closely with palliative care team & case management will help you understand options available depending on payor source. Don't overpromise! #SoMe4Trauma #SoMe4Surgery
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For more info on Palliative Care in trauma pts, check out @EAST_Traumacast episode on Palliative Care in Acute Care Surgery. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/pal…
For more info on Palliative Care in trauma pts, check out @EAST_Traumacast episode on Palliative Care in Acute Care Surgery. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/pal…
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For more info on surgical palliative care in general, check out my podcast, The Surgical Palliative Care Podcast, @Surgpallcare. The latest episode is an interview with @zaracMD @CSPH_BWH, acute care surgeon @BrighamWomens. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/dr-…
For more info on surgical palliative care in general, check out my podcast, The Surgical Palliative Care Podcast, @Surgpallcare. The latest episode is an interview with @zaracMD @CSPH_BWH, acute care surgeon @BrighamWomens. #SoMe4Trauma #SoMe4Surgery
podcasts.apple.com/us/podcast/dr-…
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Another great resource is Surgical Palliative Care (2019). It contains useful information on primary palliative care skills:
-how to discuss code status
-how to run family meeting
-prognostication
-basic symptom management
#SoMe4Trauma #SoMe4Surgery
global.oup.com/academic/produ…
Another great resource is Surgical Palliative Care (2019). It contains useful information on primary palliative care skills:
-how to discuss code status
-how to run family meeting
-prognostication
-basic symptom management
#SoMe4Trauma #SoMe4Surgery
global.oup.com/academic/produ…
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Lastly, from @RWJF: links to more than two dozen articles about Surgical Palliative Care published in @JAmCollSurg
promotingexcellence.org/surgeons/
WE HEAL WITH MORE THAN STEEL.
Dr. Balfour Mount is pictured below in the OR! Thank you for reading.
#SoMe4Trauma #SoMe4Surgery
Lastly, from @RWJF: links to more than two dozen articles about Surgical Palliative Care published in @JAmCollSurg
promotingexcellence.org/surgeons/
WE HEAL WITH MORE THAN STEEL.
Dr. Balfour Mount is pictured below in the OR! Thank you for reading.
#SoMe4Trauma #SoMe4Surgery
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