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Updated: May 22, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Why do palliative care patients present to the emergency department? Avoidable or unavoidable?
Elaine M Wallace1, Mary C Cooney, Jackie Walsh
1Department of Palliative Medicine, Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland. drelainewallace@gmail.com
The American Journal of Hospice & Palliative Care
|May 26, 2012
Summary
Many emergency department (ED) visits by palliative care patients are avoidable. Improving communication and support for caregivers can prevent unnecessary end-of-life hospitalizations.
Area of Science:
- Palliative Care
- Emergency Medicine
- Health Services Research
Background:
- End-of-life care for advanced illness patients presenting to the Emergency Department (ED) causes distress.
- Understanding reasons for ED visits can inform interventions to prevent them.
Purpose of the Study:
- Identify patients under specialist palliative care service (SPCS) who attended the ED.
- Determine the avoidability of these potentially distressing ED presentations.
Main Methods:
- Retrospective review of 35 ED presentations by 30 palliative care patients over 6 months.
- Assessed avoidability based on alternative care options (home care, family physician, hospice).
Main Results:
- 51.5% of ED presentations were deemed avoidable.
- Common reasons for visits included dyspnea, nausea/vomiting/constipation, and uncontrolled pain.
- Most presentations (94%) resulted in hospitalization, with 50% of patients dying within one month.
Conclusions:
- A significant proportion of ED visits by palliative care patients are avoidable.
- Enhanced communication, caregiver confidence, and practical support are crucial.
- Integrated community and acute specialist palliative care services can reduce inappropriate ED use.
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