End of Life Symptom Management in the Emergency Department

The Emergency Department is at times the only place patients can turn to for symptom relief. In an aging population, this means that more patients are presenting to the ED towards the end of life (EOL). Emergency medicine (EM) prides itself as a specialty that handles disease-directed treatment for a variety of acute conditions. In contrast, palliative care (PC) is focused on improving the quality of life (QOL). It has become essential for EM physicians to care for patients who are not seeking life-sustaining measures, but instead quality of life interventions. Patients with serious illness, even hospice patients, present to the ED at increasing numbers for symptom management. Unfortunately, there is a lack of training and guidelines for EM physicians in symptom management of EOL care. The development of a clear, concise protocol for the most common acute symptoms at the EOL can provide a framework for ED providers to adequately address the needs of patients at the EOL