Archive for the ‘Palliative Care’ Category

End-of-life symptoms

November 23, 2014

PANDA

  • Pain – consider diamorphine 2.5 mg SC hourly PRN, adjust as required
  • Agitation – consider midazolam 2.5 mg SC hourly PRN, adjust as required
  • Nausea and vomiting – consider haloperidol 0.5-2 mg QDS PRN, cyclizine, levomepromazine 3.125-6.25 mg SC
  • Dyspnoea – consider regular morphine, steroids, diazepam
  • Airway¬†secretions – consider hyoscine butylbromide 20 mg SC TDS PRN

Consider palliative care team review and syringe driver

Source here

Recognising end-of-life

November 22, 2014

Inert People Breath Slowly (to be used in the clinical context)

  • Infections / ulcers that are recurrent or persistent
  • Progressive weight loss (>10% over last six months)
  • Breathlessness at rest or minimal exertion (MRC scale 4/5)
  • Self-care reduced or lack of interest (in a chair >50% of the time)

More information here