What are palliative care emergencies?

Unexpected clinical emergencies may arise abruptly in palliative and end-of-life care. If prompt medical intervention is not provided, these emergencies can impact a patient’s well-being and overall quality of life. Additionally, such situations can be highly distressing for both patients and their companions. It is crucial to identify patients who may be susceptible to such emergencies and establish a proactive plan if an emergency does occur.

Professionals in health and social care must possess the ability to recognise indicators and manifestations of emergencies in palliative care. Furthermore, they should be knowledgeable about the appropriate procedures for promptly securing urgent medical referrals when necessary.

Common palliative care emergencies

It is essential to be prepared for a range of critical situations. These common palliative care emergencies encompass physical challenges such as pain crises, dyspnea, and seizures, as well as emotional and spiritual distress, which require sensitive and immediate attention.

Pain Crisis

A sudden and severe pain that cannot be adequately managed with the patient’s regular pain control measures.

Dyspnea (Breathlessness)

An acute and intense difficulty in breathing, particularly distressing for patients with advanced illnesses.

Nausea and Vomiting

Persistent and uncontrollable nausea and vomiting that standard anti-nausea medications cannot alleviate.

Seizures

Episodes of uncontrolled muscle activity that can manifest in patients with neurological conditions, such as brain metastases.

Delirium

Rapid changes in mental status, often triggered by metabolic imbalances or medication side effects, along with emotional distress and spiritual concerns, necessitating immediate attention.

Emotional Distress

Intense emotional suffering and psychological anguish requiring immediate support within the palliative care context.

Spiritual Distress

Profound spiritual or existential struggles that significantly impact the patient’s well-being, necessitating compassionate and empathetic care.

Preparing for an emergency

To ensure the highest level of patient care and safety, it is imperative for healthcare professionals to implement a comprehensive approach that includes the following key steps:

• Identify high-risk patients, like those with cancer; consult emergency guidelines for risk factors.
• Monitor changes in risk during staff handovers, especially if the illness progresses. Understand patient preferences for emergency situations, such as hospital admission or DNACPR orders.
• Communicate sensitively with the patient’s approval to prepare those close to them for potential emergencies.
• Know emergency contacts based on local policies, both during and after normal working hours.
• Recognize common emergencies and understand your role in the care team during such situations.

Planning for an emergency as a carer

It can be good to create a back up care plan to ensure the well being of a loved one that you may be caring for or living with. This back up care plan would involve identifying a family member or friends who can serve as a back up carer, obtaining essential information about their healthcare needs. This would include:

• Formulating an emergency plan
• Getting copies of documents and emergency plans set in place by professionals
• Discussing what you would need to do
• Informing the council of your role as a caregiver
• Saving emergency numbers on your phone

For more information on becoming a carer for your loved one to support them with palliative care emergencies, take a look at this article published by Marie Curie.

Dealing with an emergency

When dealing with an emergency in palliative care:

• Try to stay calm
• Call for help
• Clearly explain what’s happening to the patient and any family, friends or carers who are there
• Tell any family or friends who are not there about the emergency, if appropriate.

How can Cavendish Homecare help?

At Cavendish Homecare we are experts in providing palliative homecare for individuals with terminal illnesses who want to remain in their own homes. We work to support the patients and their families with sensitive and comforting palliative care in London.

If you would like to enquire about our palliative care, contact us on, 020 3008 5210 or email us at info@cavendishhomecare.com.