科研之友
微信
新浪微博
Facebook
分享链接
摘要
Purpose Depending on the researched region, the portion of patients with underlying palliative care disease during the overall emergency medicine mission amounts to 3-10% (approx. 1% in the terminal stage). Here, the spectrum is wide, and consists of symptomatic crises, socio-psychological strains of the environment, hence emergencies independent of the disease, up to emergencies requiring a resuscitation. Hereby exists an area of conflict between the curative approach of the medical emergency mission and the palliative care therapy in form of symptom control on the site. Under time pressure, an overall evaluation of the situation is required, and medical, legal and ethical aspects are to be considered in the interest of the patient. Therefore, a question has been posed, which structures and forms of aid are available to an emergency medicine physician during emergency cases affiliated with palliative care patients. Materials and Methods A collection of data addressing the quality of structure during medical emergency care for palliative care patients based on survey responses of Chiefs of Emergency Medicine in the region Ostwestfalen-Lippe and the city of Munster. Results Response rate 8/8. Pool of consistently active emergency medicine physicians per regional administrative body (71-80); hereof medical doctors with a sub-specialty in palliative care medicine (0-10). Question selection: structure data of each headquarters (...): Palliative care medicine contact data (i.e. mobile number) for the dispatcher yes (1), no (7). Structure data for advance-care planning: Quality care circle/meeting emergency medicine/palliative care medicine network yes (2), no (6), planned (1), regional standardized emergency identification cards yes (4), no (4), planned (1). Decision making aid during emergency medical mission: SOP serving as a decisions making guide available yes (3), no (5), planned (1), MAD-systems yes (8), overall amount of Morphinsulfat on site >= 40 mg yes (7), no (1). Discussion and Conclusion Options offering a palliative care approach within the field of emergency medicine have thus far been implemented inconsistently. The above applies toward advanced training concerning the medical, legal and ethical issues, medical emergency equipment and aid, as well as the cooperation with outpatient partners. Any potenzial conflicts and overlaps should be identified and discussed on a regional level and beyond. The aim is a sovereign and sophisticated approach between a curative therapy and a palliative symptom control in order to serve in the interest of the patient.
- 出版日期2017-10
