Palliative, end-of-life care for the burn-injured patient

This review seeks to describe end-of-life trajectories in burns patients, and a holistic approach to care which encompasses the patient, the family and the health care professionals who care for them. It includes relevant considerations in determining the indications for end-of-life care rather than active treatment aimed at cure. Care for the dying burns patient is described in emergency department, intensive care and ward settings. Inclusive communication to ensure appropriate and consensus-based decision-making which is supported by the treating team, patient and family is paramount in developing a shared understanding of the aims of required interventions. Checklists and guidelines support these aims, and examples are provided, along with details of practical challenges in care delivery. The importance of an established pathway to offer organ donation to burns patients with unsurvivable injuries is highlighted, and outcomes from our institution are reported.