What are the names of each hospital where there is an emergency department (ED)(A&E)in your trust?
Royal Blackburn Hospital. (Other units are urgent care centres or minor injury units).
For each ED (A&E) in your trust could you answer the following: Is there a Medical End of life (EOL)/Palliative Care Lead in the ED?
Yes.
Is there a Nursing End of life (EOL)/Palliative Care Lead in the ED?
Yes.
Does the ED have access to palliative care advice/guidance/input? If so, what hours is this for? What type of service is this; is it an in person, phone advice, is it nursing or medical lead?
Yes, 08:30 - 16:30 7 days a week. In person and phone advice. Nurse led.
Does your ED have specific resources for patients who are dying/ EOL in the ED? - What are these resources?
Yes. Anticipatory medication commencement and supportive pre bereavement care for patients and families where suitable. A hospital bed will be obtained for comfort purposes.
Is there a specific space in your ED for patients who are dying to be looked after by the ED team?
A side room will be sourced to nurse the patient to maintain privacy and dignity.
Is there a fast-track option to a side room in the hospital for patients who are recognised as dying in the ED? The Clinical Site Manager will be made aware if an EOL patient needs admission and this will be accommodated dependent on the bed base.
Are you able to Fastrack dying patients’ home from the ED?
Yes.
Does your ED prescribe anticipatory meds for the patient to go home with? If not, who does this?
Yes.
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Does your department use RESPECT forms? If not, what do you use for your DNACPR options?
Yes.
Is your department able to access religious support 24 hours a day?
Yes, in and out of hours for all faiths.
What are you first line medications recommended for each of the following Agitation, Analgesia (Pain), Respiratory Secretions and Nausea and Vomiting?
Agitation - Midazolam. Analgesia - Morphine. Respiratory Secretions - Hyosine.
Nausea and Vomiting - Ondansetron.
Do you have a specific ED prescription with electronic or paper for these medications?
Yes, electronic on Cerner.
Are you able to share any of your specific ED documentation or guidelines that you use for EOL care and the dying patient both nursing and medical?
Within Cerner our electronic patient record you can put through requests to the bereavement team as follows:
Referral to End of Life and Bereavement Team Breathlessness – End of Life
Other – End of Life Pain – End of Life
Chest Secretions – End of Life Family Considerations – End of Life Nausea & Vomiting – End of Life
Restlessness & Agitation – End of Life Spirituality & Psychological needs – End of Life
