Palliative Care. Dr Rachel Dawson. Objectives. Increase your confidence in dealing with palliative care cases. Content. Who is a palliative care patient? Presentation/ likely symptoms Palliative care emergencies Help available Medication – what, when & how much to use
Dr Rachel Dawson
- Any end-stage chronic illness; cancer, heart failure, renal failure, COPD, MS ….
- Old age
COMMUNITY offer symptom relief only
District Nurses ->LCP
Hospice at home ->LCP
Pharmacist – Twycross/ Pall care BNF
Bradford Cancer Support ->benefits
2nd opinionHelp Available
- Prescribe regular laxatives
- Remember Co-danthrusate/ docusate
- Seek nurse advice/ involvement
Has multiple uses at different doses & compatible in syringe drivers
If opioid naïve a good starting point for oral route:
- Try & anticipate
- Team decision
- Can always be stopped
- Ensure family aware.
- Communicate well
- STOP all other meds (special considerations – Insulin)
- Diamorphine (5-10mg if naïve) – 15 amps
- Inform/ Involve family in decision
- Inform DN’s or H at H
- Prescribe meds
- Write up instructions – Syringe driver & stat sheet. Be clear.
- Yorkshire cancer network booklet
- Dose comparisons of Strong Opioids
- Syringe driver compatability info
- Local pharmacy info (exemption form)
- Forms – DNR, Level 6, LCD, Syringe driver, PEPSI COLA + DS1500 advice.