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 there is an emergency.
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.
This information is for health and social care professionals. You can use our My Learning form to reflect on how this page has helped with your continuing professional development. Download the form.
Key points
- Know which are the common emergencies in palliative care that need urgent medical treatment.
- Find out if your patient is at risk of any emergencies.
- Know how to recognise the signs and symptoms of these emergencies.
- Find out if your patient has planned for the care they would like to receive in an emergency.
- Know who you need to call during 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.
Common palliative care emergencies
Emergencies that affect people with a terminal illness, such as advanced cancer, include:
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:
- agitation
- seizures (this information is for patients, but may be useful for you too)
- emotional distress
- spiritual distress.
You can help patients and the people important to them, by talking to them about any concerns they have about the person's symptoms or their care.
Preparing for an emergency
Prepare for an emergency in the following ways:
- Find out which patients are at risk of any emergencies. Read our emergency pages to find out who is most at risk. See Common palliative care emergencies.
- Note any changes in risk at each staff handover. For example, if cancer has spread to other parts of the body.
- Find out if they have an emergency care plan or would like to make one. It could include, for example, if 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).
- With the patient's permission, help the people important to them understand what to expect if there is an emergency. 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.
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 people important to the patient 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.
You, or someone else who has been affected by what's happened, can also contact our free Support Line on 0800 090 2309.