BMJ  2007;334:1274 (16 June), doi:10.1136/bmj.39157.685220.47

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Communication—the forgotten palliative care emergency

Mark Pickering, senior house officer, Rob George, locum consultant

Lions Hospice, Gravesend, Kent

dr.mark@totalise.co.uk

The first 150 words of the full text of this article appear below.

Palliative care emergencies are well recognised. Hypercalcaemia, spinal cord compression, and obstruction of the superior vena cava are standard fare in terminal illness, and their management is often taught. But how often do we recognise communication as a genuine palliative care emergency?

A 67 year old man was transferred to our hospice from the local district general hospital on a Friday. He had end stage cardiac failure, and an implantable cardioverter defibrillator was in place. The referral was clear enough: he was coming to us to die. Just as clear was the fact that he didn't know his prognosis but was apparently expecting rehabilitation.

By the time I (MP) had admitted him he had turned blue three times, and during one of these cyanotic attacks the defibrillator had discharged. It was clear that he was very near the end. As I began to explore his understanding of the illness and . . . [Full text of this article]


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emergency communication: be careful
Álvaro Sanz, et al.
bmj.com, 15 Jun 2007 [Full text]
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