| Recognition of palliative care and hospice needs in ED patients |
- Prognostication and trajectories of dying (eg, terminal illness, sudden death, organ failure, frailty)
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- Screening for palliative care needs in patients (also identifying when to consult palliative care and/or hospice)
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- Rapid palliative care assessment (eg, aligning goals, functional assessment, caregiver burden, etc)
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- Treating complications of malignant disease (eg, spinal cord compression) and its treatment (eg, tumor lysis)
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- Ethnic, spiritual, and cultural issues around the end-of-life and death
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| Primary-level provider skills |
- Pain management (including chronic and malignancy-related pain)
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- Treating common end-of-life and other distressing symptoms (eg, nausea/vomiting, dyspnea)
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- Difficult communication (including serious news of prognosis, death disclosure, and conflict)
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- Goals of care discussions (assisting family and patients with shared decision-making)
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- Caregiver support
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- Noninitiation or stopping of nonbeneficial interventions (such as ventilator, pressors, etc)
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- Care for the imminently dying (expected death within hours to days) or recently deceased patient
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- Bereavement and grieving
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- Family presence during resuscitation
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- Caring for patients under hospice care
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- Coping and self-care
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- End-of-life management in a mass casualty incident/event
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| Logistic understanding related to palliative care in the ED |
- Advance directives and planning
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- Ethical and legal issues (eg, decision-making capacity, futility)
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- Multidisciplinary team and support systems (understanding team roles and system/community resources)
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- Transitions across care settings (eg, inpatient versus home hospice, palliative care unit)
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