Thread by @georgebellstarr

Final lightening season of the day for me, @AAndybrereton - EoL Case Studies and working as a Paramedic in EoL care.

Andy opens by explaining his route to becoming a specialist EoL paramedic.

Paramedic > EoL HCA > B5 ‘nursing role’ > Training role > Specialist role

#SWPiPC

A remainder before we start from @AAndybrereton - this could be emotive, if you need to take a minute, please do, remember to be kind to yourself.

#SWPiPC

Andy continues by bringing in some real (highly anonymised) cases.

In @AAndybrereton’s locality, family are trained to deliver stat doses of analgesics.

Highlighting that often doses of analgesics are much higher than paramedics are used to.

Patient in this case was given 200mg oxycodone, which is approx 300mg oral morphine.

Highlighting that it can take a significant amount of analgesia to get pain under control

#SWPiPC

Next case:

A patient with a chronic disease, rather than a cancer.

A reminder that hospice is not just for cancer.

#SWPiPC

Anticipatory grief can challenging in these cases.

Often with chronic disease there can be periods of decline before recovery for a number of months/years.

Using explicit language can help, especially with relatives.

Final case:

Balancing patient wishes and family wishes.

The challenging situation of patient wishing to cease treatment, family want them to try any treatment - an incredibly emotive period.

@AAndybrereton role became mediator, spending time with both parties….

…explaining that we must respect the patients wishes.

Personally I cannot imagine how challenging that process must have been.

Listening to @AAndybrereton has been inspirational.

Death, and the process of dying will happen to all of us. However, it is not always dignified.

Andy, is clearly spearheading the paramedic progress in this arena - thank you!

#SWPiPC