A Model for Emergency Department End-of-life Communications After Acute Devastating Events-Part II: Moving From Resuscitative to End-of-life or Palliative Treatment

The model for emergency department (ED) end‐of‐life communications after acute devastating events addresses decision‐making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliativ...

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Bibliographic Details
Published in:Academic emergency medicine 2012-11, Vol.19 (11), p.1300-1308
Main Authors: Limehouse, Walter E., Ramana Feeser, V., Bookman, Kelly J., Derse, Arthur
Format: Article
Language:English
Subjects:
Communication
Critical Illness - therapy
Decision Making
Decision making models
Emergency medical care
Emergency Medicine - organization & administration
Emergency Service, Hospital - organization & administration
Female
Humans
Male
Models, Organizational
Outcome Assessment (Health Care)
Palliative care
Palliative Care - organization & administration
Physicians
Resuscitation - standards
Resuscitation - trends
Terminal Care - organization & administration
United States
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Summary:The model for emergency department (ED) end‐of‐life communications after acute devastating events addresses decision‐making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end‐of‐life treatments. After completing the steps involved in determining decision‐making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end‐of‐life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. Resumen Un Modelo de Comunicación para el Final de la Vida en un Servicio de Urgencias tras Acontecimientos Devastadores Repentinos. Parte II: Del Tratamiento Resucitador al Tratamiento Paliativo o del Final de la Vida El modelo de comunicación para el final de vida en un servicio de urgencias tras eventos devastadores repentinos comprende la capacidad en la toma de decisiones, los representantes legales y las directrices avanzadas, que incluyen las definiciones legales y la aplicación de estos pasos. La parte II trata de la comunicación del cambio de los tratamientos de reanimación por los tratamientos paliativos o de cuidados al final de la vida. Tras completar los pasos implicados en la determinación de la toma de decisión, los urgenciólogos deberían considerar iniciar las medidas paliativas versus continuar con el tratamiento resucitador. Como las comunicaciones relacionadas con estas decisiones del final de la vida re caen cada vez más en el ámbito de la medicina de urgencias y emergencias, se necesita estar formado y a sentirse cómodo con ellas.
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.12018