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Past, present, and future of palliative care in emergency medicine in the USA

机译:过去,礼物和未来的姑息治疗在美国的紧急医学中

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The emergency department (ED) provides immediate access to medical care for patients and families in times of need. Increasingly, older patients with serious illness seek care in the ED, hoping for relief from symptoms and suffering associated with advanced disease. Until recently, emergency medicine (EM) clinicians have been ill‐equipped to meet the needs of patients with serious illness, and palliative services have been largely unavailable in the ED. However, in the past decade, there has been growing recognition from within both the EM and palliative medicine communities on the importance of palliative care provision in the ED. The past 10?years have seen a surge in EM–palliative care training and education, quality improvement projects, and research. As a result, the practice paradigm within EM for the seriously ill has begun to shift to incorporate more palliative care practices. Despite this progress, substantial work has yet to be done in terms of identifying ED patients in need of palliative care, training EM clinicians to provide high‐quality primary palliative care, creating pathways for ED referral to palliative care and hospice, and researching the outcomes and impact of palliative care provision on patients with serious illness in the ED. To meet the growing needs of older adults with serious illness in the emergency department, changes are steadily occurring in the practice of emergency medicine in the USA to incorporate palliative care.
机译:急诊部(ED)在需要时立即对患者和家庭进行医疗服务。越来越多的老年患者严重的疾病寻求护理,希望缓解与晚期疾病相关的症状和痛苦。直到最近,急诊药物(EM)临床医生已经令人不满,以满足严重疾病的患者的需求,而姑息服务在ed方面在很大程度上无法使用。然而,在过去的十年中,在EM和姑息医学社区中越来越高的认可,了解了ED中姑息治疗的重要性。过去10年有所了解了EM-Palliative Care培训和教育,质量改进项目和研究的激增。因此,EM为严重生病的实践范例已经开始转移以纳入更多的姑息治疗实践。尽管有了这一进展,但在识别需要姑息治疗的ED患者方面尚未完成,培训EM临床医生提供高质量的主要姑息治疗,为助攻和临界提供高质量的主要姑息治疗,以及研究结果姑息治疗患者对艾德严重疾病患者的影响。为了满足急诊部门严重疾病的老年人不断增长的需求,在美国紧急医学的实践中稳步发生变化,以弥合姑息治疗。

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