Palliative care in the trauma ICU
Kathleen O'Connell1, Ronald Maier
1Department of Surgery, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Current Opinion in Critical Care
|September 24, 2016
Summary
Palliative care integration in surgical settings is crucial for critically ill patients, especially the elderly. Embracing palliative medicine ensures goal-concordant care and improves patient-centered outcomes.
Area of Science:
- Trauma Surgery
- Palliative Care
- Geriatric Medicine
Background:
- Palliative care benefits for critically ill patients are established but not widely adopted in surgical culture.
- An increasing number of geriatric trauma patients necessitates better integration of palliative medicine.
Purpose of the Study:
- To highlight the imperative of integrating palliative medicine into intensive care for goal-concordant care in trauma patients.
- To address misconceptions and improve the acceptance of palliative care within surgical practice.
Main Methods:
- Review of current practices and literature regarding palliative care in trauma surgery.
- Discussion of the impact of aggressive end-of-life care on family perception.
- Introduction of a geriatric-specific prognosis calculator for initiating goals of care discussions.
Main Results:
- Misconceptions about palliative care for trauma patients persist among surgeons.
- Aggressive end-of-life care does not improve family perception of care.
- Elderly patients' preferences for palliative over life-extending treatments are often unmet.
Conclusions:
- Shifting quality metrics from mortality rates to symptom control and patient preferences is essential.
- Acute care surgeons should take ownership of surgical palliative care to ensure patient-centered care.
- Integrating palliative care optimizes care for trauma patients with incurable conditions.
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