Assessment
Patient Care Goals
To provide relief from pain and other distressing symptoms. To assist the family and loved ones in understanding the dying process, normalizing the death process, and providing support. To allow patients to remain comfortable in their home when possible.
| Pediatric Pearls: | Signs & Symptoms: | Differential: |
| □ Call medical direction for assistance with pediatric hospice patients | □ None | □ None |
Clinical Management Options
| EMT-B |
| • Offer comfort measures: fan, bedding, food/drink, etc. • Contact hospice or palliative care provider for medical control orders |
| Paramedic |
| • Treat pain with hospice plan/home meds or use follow Pain Management COG • Treat nausea and vomiting • Treat agitation/anxiety with hospice plan/home meds or use: • Midazolam • Droperidol • Opioids can help with respiratory distress |
Pearls
- Careful and thorough assessments should be performed to identify complaints not related to the illness for which the patient is receiving hospice or palliative care.
- Care should be delivered with the utmost patience and compassion.
- Families often call because they do not understand the dying process. Normalizing the dying process can be helpful for families.
- Patient’s can sometimes appear to be short of breath. Pain medications such as fentanyl can help reduce this discomfort.
- Consider non-medication options as well (ie. A fan blowing on a patient’s face can help reduce air hunger).
CHEMS Field Treatment Guidelines 