Skip to main content Accessibility help
  • Print publication year: 2014
  • Online publication date: January 2014

30 - Palliative and end-of-life care in the emergency department

from Section 4 - Special topics

Related content

Powered by UNSILO


1. Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: final data for 2005. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2008;56:1–120.
2. NHAMCS 2008. National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary Tables.
3. Shugarman, LR, Lorenz, K, Lynn, J. SUPPORT study; End-of-life care: An agenda for policy improvement. Clin Geriatr Med. 2005;21(1):255–72.
4. Morden NE, Chang CH, Jacobson JO, et al. End-of-life care for Medicare beneficiaries with cancer is highly intensive overall and varies widely. Health Aff (Millwood). 2012;31(4):786–96.
5. Barnato AE, Herndon MB, Anthony DL, et al. Are regional variations in end-of-life care intensity explained by patient preferences? Med Care. 2007;45(5):86–393.
6. AAHPM, American Academy of Hospice and Palliative Medicine. Statement on Clinical Practice Guidelines for Quality Palliative Care (2006, online, accessed August 15, 2012).
7. Campbell ML, Guzman JA. Impact of a proactive approach to improve end-of-life care in a medical ICU. Chest. 2003;123:266–71.
8. Delgado-Guay MO, Parsons HA, Li Z, Palmer LJ, Bruera E. Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team. Cancer. 2009;115:437–45.
9. Gelfman LP, Meier DE, Morrison RS. Does palliative care improve quality? A survey of bereaved family members. J Pain Symptom Management. 2008;36:22–8.
10. Smith AK, Fisher J, Schonberg MA, et al. Am I doing the right thing? Provider perspectives on improving palliative care in the emergency department. Ann Emerg Med. 2009;54(1):86–93.
11. Lunney JR, Lynn J, Hogan C. Profiles of older medicare decedents. J Am Geriatr Soc. 2002;50:1108–12.
12. Mitchell SL, Kiely DK, Hamel MB, et al. Estimating prognosis for nursing home residents with advanced dementia. JAMA. 2004;291(22):2734–40.
13. Chan GK. Trajectories of approaching death in the emergency department: clinician narratives of patient transitions to the end of life. J Pain Symptom Manage. 2011;42(6):864–81.
14. Hancock K, Clayton JM, Parker SM, et al. Discrepant perceptions about end-of-life communication: a systematic review. J Pain Symptom Manage. 2007;34(2):190–200.
15. Fried TR, Bradley EH, O’leary J. Prognosis communication in serious illness: perceptions of older patients, caregivers, and clinicians. J Am Geriatr Soc. 2003;51:1398–403.
16. Christakis NA, Lamont EB. Extent and determinants of error in doctors’ prognoses in terminally ill patients: prospective cohort study. BMJ (Clin Res ed.). 2000;320(7233):469–72.
17. Glare P, Virik K, Jones M, et al. A systematic review of physicians’ survival predictions in terminally ill cancer patients. BMJ (Clin Res ed.). 2003;327:195–8.
18. Meropol NJ, Weinfurt KP, Burnett CB, et al. Perceptions of patients and physicians regarding phase I cancer clinical trials: implications for physician-patient communication. J Clin Oncol. 2003;21(13):2589–96.
19. Weeks JC, Cook EF, O’day SJ, et al. Relationship between cancer patients’ predictions of prognosis and their treatment preferences. JAMA. 1998;279(21):1709–14.
20. Haidet P, Hamel MB, Davis RB, et al. Outcomes, preferences for resuscitation, and physician-patient communication among patients with metastatic colorectal cancer. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Am J Med. 1998;105(103):222–9.
21. Lamont EB, Siegler M. Paradoxes in cancer patients’ advance care planning. J Palliat Med. 2000;3(1):27–35.
22. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064–7.
23. Peberdy MA, Kaye W, Ornato JP, et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation. 2003;58(3):297–308.
24. Ebell MH, Becker LA, Barry HC, Hagen M. Survival after in-hospital cardiopulmonary resuscitation. A meta-analysis. J General Intern Med. 1998;13(12):805–16.
25. Sasson C, Rogers MA, Dahl, J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circulation Cardiovascular Qual Outcomes. 2010;3(1):63–81.
26. Reisfield GM, Wallace SK, Munsell MF, et al. Survival in cancer patients undergoing in-hospital cardiopulmonary resuscitation: a meta-analysis. Resuscitation. 2006;71(2):152–60.
27. Ewer MS, Kish SK, Martin CG, Price KJ, Feeley TW. Characteristics of cardiac arrest in cancer patients as a predictor of survival after cardiopulmonary resuscitation. Cancer. 2001;92(7):1905–12.
28. Heyland DK, Frank C, Groll D, et al. Understanding cardiopulmonary resuscitation decision making: perspectives of seriously ill hospitalized patients and family members. Chest. 2006;130(2):419–28.
29. Murphy DJ, Burrows D, Santilli S, et al. The influence of the probability of survival on patients’ preferences regarding cardiopulmonary resuscitation. N Engl J Med. 1994;330(8):545–9.
30. El-Jawahri A, Podgurski LM, Eichler AF, et al. Use of video to facilitate end-of-life discussions with patients with cancer: a randomized controlled trial. J Clin Oncol. 2010;28(2):305–10.
31. Stone SC, Abbott J, Mcclung CD, et al. Paramedic knowledge, attitudes, and training in end-of-life care. Prehosp Disaster Med. 2009;24(6):529–34.
32. Sherbino J, Keim SM, Davis DP. Clinical decision rules for termination of resuscitation in out-of-hospital cardiac arrest. J Emerg Med. 2010;38(1):80–6.
33. Grudzen CR, Hoffman JR, Koenig WJ, et al. The LA story: what happened after a new policy allowing paramedics to forgo resuscitation attempts in pre-hospital cardiac arrest. Resuscitation. 2010;81(6):685–90.
34. Burnod A, Lenclud G, Ricard-Hibon A, et al. Collaboration between pre-hospital emergency medical teams and palliative care networks allows a better respect of a patient’s will. Eur J Emerg Med. 2012;19(1):46–7.
35. Morrison LJ, Kierzk G, Diekema, DS, et al. Part 3: Ethics: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl. 3):S665–75.
36. Kleinman MD, deCaen AR, Chameides L, et al. Part 10: Pediatric Basic and Advanced Life Support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010;122(16 Suppl. 2):S466–515.
37. Dingerman RS, Mitchell EA, Meyer EC, Curley, MA. Parent presence during complex invasive procedures and cardiopulmonary resuscitation: a systematic review of the literature. Pediatrics. 2007;120(4):842–54.
38. Dudley NC, Hansen KW, Furnival RA, et al. The effect of family presence on the efficiency of pediatric trauma resuscitations. Ann Emerg Med. 2009;53(6):777–84.
39. Tinsley C, Hill JB, Shah J, et al. Experience of families during cardiopulmonary resuscitation in a pediatric intensive care unit. Pediatrics. 2008;122(4):e799–804.
40. Farah MM, Thomas CA, Shaw, KN. Evidence-based guidelines for family presence in the resuscitation room. A step-by-step approach. Pediatr Emerg Care. 2007;23(8):587–91.
41. Desandre PL, May K. Palliative care in the emergency department. In Oxford Textbook of Palliative Medicine, 5th edn, ed. Cherny N, Fallon M, Kaasa S, Portenoy R, Currow D [To be published by Oxford University Press in 2014].
42. Institute of Medicine. Hospital Based Emergency Care: At the Breaking Point (Washington, DC: Institute of Medicine, 2006).
43. Casarett D, Pickard A, Bailey FA, et al. Do palliative consultations improve patient outcomes? J Am Geriatr Soc. 2008;56(4):593–9.
44. Morrison RS, Penrod JD, Cassel JB, et al. Cost savings associated with US hospital palliative care consultation programs. Arch Intern Med. 2008;168(16):1783–90.
45. Mahony SO, Blank A, Simpson J, et al. Preliminary report of a palliative care and case management project in an emergency department for chronically ill elderly patients. J Urban Health. 2008;85(3):443–51.
46. Glajchen M, Lawson R, Homel P, Desandre P, Todd KH. A rapid two-stage screening protocol for palliative care in the emergency department: a quality improvement initiative. J Pain Symptom Manage. 2011;42(5):657–62.
47. Richards CT, Gisondi MA, Chang CH, et al. Palliative care symptom assessment for patients with cancer in the emergency department: validation of the Screen for Palliative and End-of-life care needs in the Emergency Department instrument. J Palliat Med. 2011;14(6):757–64.
48. Quest T, Gisondi M, Engle K, et al. Implementation of the Screening for Palliative Care Needs in the Emergency Department (SPEED) Instrument in Two Emergency Departments (Boston, MA: Society for Academic Emergency Medicine Annual Meeting, 2011).
49. Emanuel L, Quest T. ed. Education in Palliative and End-of-life Care of Emergency Medicine (EPEC-EM) (Chicago, IL: EPEC Project, Buehler Center on Aging, Health & Society, Northwestern University, 2008).
50.In re Dinnerstein, 6 Mass. App. Ct. 466, 380 N. E. 2d, 134 (1978).
51.Cruzan v. Director of Missouri Department of Health, 109 S. Ct 3240 (1990).
52.Scheible v. Joseph Morse Geriatric Center Inc., District Court of Appeal of Florida, Fourth District, No. 4D07–3064 (2008).
53. Hickman SE, Nelson CA, Moss AH, et al. The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. J Am Geriatr Soc. 2011;59(11):2091–9.
54. Leeman C. Distinguishing among irrational suicide and other forms of hastened death: implications for clinical practice. Psychosomatics. 2009;50(3):185–91.
55. Entwistle V, Carter SM, Cribb A, Mccaffery K. Supporting patient autonomy: the importance of clinician-patient relationships. J Gen Intern Med. 2010;25(7):741–45.
56. National Comprehensive Cancer Network (2012). Adult Cancer Pain, v. 1.2012. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines).
57. American Pain Society. Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain, 6th edn (Glenview, IL: American Pain Society, 2008).
58. Campbell ML. Dyspnea prevalence, trajectories, and measurement in critical care and at life’s end. Curr Opin Support Palliative Care. 2012;6(2):168–71.
59. Jennings AL, Davies AN, Higgins JP, Gibbs JS, Broadley KE. A systematic review of the use of opioids in the management of dyspnoea. Thorax. 2002;57(11):939–44.
60. Mahler DA. Understanding mechanisms and documenting plausibility of palliative interventions for dyspnea. Curr Opin Support Palliative Care. 2011;5(2):71–6.
61. Von Leupoldt A, Sommer T, Kegat S, et al. Down-regulation of insular cortex responses to dyspnea and pain in asthma. Am J Resp Crit Care Med. 2009;180(3):232–8.
62. Ben-Aharon I, Gafter-Gvili A, Paul M, Leibovici L, Stemmer SM. Interventions for alleviating cancer-related dyspnea: a systematic review. J Clin Oncol. 2008;26(14):2396–404.
63. Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med. 2000;160(6):786–94.
64. Centeno C, Sanz A, Bruera E. Delirium in advanced cancer patients. Palliative Med. 2004;18(3):184–94.
65. Chow GV, Czarny MJ, Hughes MT, Carrese JA. CURVES: a mnemonic for determining medical decision-making capacity and providing emergency treatment in the acute setting. Chest. 2010;137(2):421–7.
66. Curtis, J. Interventions to improve care during withdrawal of life-sustaining treatments. J Palliat Med. 2005;8(Suppl. 1):16–31.
67. Chan JT, Treece PD, Engleberg RA, et al. Association between narcotic and benzodiazepine use after withdrawal of life support and time to death. Chest. 2004;126(1):286–93.
68. Campbell MB, Bizeck KS, Thill M. Patient responses during rapid terminal weaning from mechanical ventilation: A prospective study. Crit Care Med. 1999;27(1):73–7.
69. Savory E, Marco CA. End-of-life issues in the acute and critically ill patient. Scand J Trauma Resusc Emerg Med. 2009;17(21):doi: 10.1186/1757-7241-17-21.
70. Lamba S, Nagurka R, Murano T, Zalenski RJ, Compton S. Early identification of dying trajectories in emergency department patients: Potential impact on hospital care. J Palliat Med. 2012;15(4):392–5.
71. Ferris FD. Last hours of living. Clin Geriatr Med. 2004;20(6):641–67.
72. Abraham JL. The Last Days…and the Bereaved. A Physician’s Guide to Pain and Symptom Management in Cancer Patients (Baltimore, MD: The Johns Hopkins University Press, 2005), pp. 397–435.
73. Bookman K, Abbott J. Ethics Seminars: Withdrawal of treatment in the emergency department. When and how? Soc Acad Emerg Med. 2006;13(12):1328–32.
74. Chan GK. End-of-life models and emergency department care. Acad Med. 2004;11(1):79–86.
75. Zieske M, Abbott J. Ethics Seminars: The hospice patient in the ED: An ethical approach to understanding barriers and improving care. Soc Acad Emerg Med. 2011;18(11):1201–7.
76. Olsen ML, Bartlett AL, Moynihan TJ. Characterizing care of hospice patients in the hospital setting. J Palliat Med. 2011;12(2):185–9.
77. Centers for Medicare & Medicaid Services, Medicare Coverage Database [online]. Updated May 25, 2012. Local Coverage Determination (LCD) for Hospice: Determining Terminal Status (L32015). [Accessed September 6, 2012].
78. Lamba S, Mosenthal AC. Hospice and palliative medicine: A novel subspecialty of emergency medicine. J Emerg Med. 2010;43(5):1–5.
79. Lamba S, Quest TE. Hospice care and the emergency department: Rules, regulations, and referrals. Ann Emerg Med. 2011;57(3):282–90.
80. Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR. Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol 1999;17(1):371–9.