Recognising emergencies in palliative care
Please be aware - this information is for healthcare professionals.
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Clinical emergencies can happen suddenly in palliative and end of life care. Without urgent medical attention, they can affect a patient's health and quality of life. They can also be very distressing for patients and those around them. It's important to recognise which patients are at risk and make a plan in case an emergency does happen.
Health and social care professionals should be able to spot the signs and symptoms of palliative care emergencies and know how to seek urgent medical referral.
On this page:
Common palliative care emergencies
Emergencies that affect people with cancer include:
- spinal cord compression
- superior vena cava obstruction
- hypercalcaemia
- neutropenic sepsis
- haemorrhage.
Patients with advanced disease have a higher risk of other medical emergencies too. This may be because the effects of the disease mean their body is less able to respond to stress and illness.
Other symptoms that may not need medical treatment but do need urgent care include:
You can help patients and the people around them by listening to and addressing their concerns about symptoms or care.
Preparing for an emergency
Prepare for an emergency in the following ways:
- Know which patients are at risk of any emergencies, for example patients with cancer. Read our emergencies pages to find out who is most at risk.
- Note any changes in risk at each staff handover. For example, if cancer has spread to other parts of the body.
- Know what the patient's wishes are if they have an emergency. For example, whether they would want to be admitted to hospital. And whether they have a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order or an Advance Decision to Refuse Treatment (known as an Advance Directive in Scotland).
- Help those close to the patient to understand what to expect if there is an emergency, with the patient's permission. Approach the conversation sensitively and be aware it may make them more worried.
- Know who to call for help in an emergency. Check with your manager and your local policy so you know who to contact in an emergency in normal working hours and out of hours.
- Know how to recognise common emergencies.
- Be clear what your role is in the care team when dealing with an emergency.
Read more about advance care planning.
Dealing with an emergency
When dealing with an emergency in palliative care:
- try to stay calm
- call for help
- clearly explain what's happening to the patient and any family, friends or carers who are there
- tell any family or friends who are not there about the emergency, if appropriate.
After an emergency
Dealing with palliative care emergencies can be distressing. If you need support afterwards, speak to your manager or colleagues, even if it's a while after it happened.
Key points
- Be aware of the common emergencies in palliative care that require urgent medical treatment.
- Be aware if your patient is at risk of any emergencies.
- Know if your patient has any advance planning about what care they would like to receive in an emergency situation.
- Know how to recognise the signs and symptoms of the common emergencies.
- Know who you should call in working hours and out of hours to get help.
- In an emergency, try to remain calm, reassure the patient and those around them and communicate clearly about what's happening.
Let us know what you think
Email your feedback to knowledgezone@mariecurie.org.uk
Disclaimer
This information is not intended to replace any training, national or local guidelines, or advice from other health or social care professionals.
The Palliative Care Knowledge Zone is not intended for use by people living with a terminal illness or their family and friends, who should access our information for the public.
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