Welcome to the palliative care section for doctors and pharmacists. This section features links to resources on palliative care guidelines, syringe driver, prescribing in palliative medicine and symptom management e.g. pain, constipation, nausea and vomiting, dry mouth and respiratory secretions.

The International Association for Hospice and Palliative Care Manual of Palliative Care 3rd Edition

The IAHPC Manual of Palliative Care is not intended to be a substitute for any textbook or reference book. Nor do its authors claim that it is exhaustive and comprehensive. It does however contain much of what is necessary for the day-to-day practice of palliative care.

  • Source: hospicecare.com
  • Clinical Resource: Manual
  • Register to Access Content: No

Fast Facts and Concepts

Fast Facts provide concise, practical, peer-reviewed and evidence-based summaries on key palliative care topics important to clinicians and trainees caring for patients facing serious illness.

  • Source: mypcnow.org
  • Clinical Resource: Summaries
  • Register to Access Content: No

Bandolier Knowledge
Palliative and supportive care

The aim is to try and gather together information of interest in palliative care.

  • Source: bandolier.org.uk
  • Clinical Resource: Evidence Based Abstracts
  • Register to Access Content: No

Pallipedia – The Free Online Palliative Care Dictionary

  • Source: pallipedia.org
  • Clinical Resource: Dictionary
  • Register to Access Content: No

palliativedrugs.com

Palliativedrugs.com provides essential independent information for health professionals about drugs used in palliative and hospice care. It includes unlicensed (unlabeled) indications and routes, and details about the administration of multiple drugs by continuous subcutaneous infusion.

  • Source: palliativedrugs.com
  • Clinical Resource: Various
  • Register to Access Content: Yes – registration is FREE for some parts of the website

Palliative Care Guidelines Plus

The site aims to offer up-to-date, evidence based information and guidance on professional aspects of palliative care.

  • Source: pallcare.info
  • Clinical Resource: Various
  • Register to Access Content: No

Palliative Care Service
Christchurch Hospital Palliative Care Service

  • Palliative Care Guidelines
    • Management of Persistent Pain in the Palliative Setting
    • Nausea and Vomiting
    • Constipation
    • Intestinal Obstruction
    • Dyspnoea
    • Cough
    • Retained Secretions
    • Hiccoughs
    • Dry Mouth
    • Sweating
    • Itch/ Pruritis
    • Agitation
    • Delirium
    • Care of the Imminently Dying
  • Health Professional Resources
    • Prescribing of Opioids
    • Subcutaneous Administration of Medications
    • Drug Information Sheets
    • Guidelines and Factsheets
    • Making Resuscitation Decisions
    • Niki T34 Syringe Pump
    • Intraspinal Analgesia
  • Source: cdhb.govt.nz
  • Clinical Resource: Guidelines
  • Register to Access Content: No

Scottish Palliative Care Guidelines

The Scottish Palliative Care Guidelines reflect a consensus of opinion about good practice in the management of adult patients with life limiting illness. They are designed for healthcare professionals from any care setting who are involved in supporting people with a palliative life-limiting condition.

Pain
Symptom Control
Palliative Emergencies
End of Life Care
Medicine Information
Patient Information

  • Source: palliativecareguidelines.scot.nhs.uk
  • Clinical Resource: Guidelines
  • Register to Access Content: No

The Palliative Care Handbook
Advice on clinical management

This handbook contains guidance to help GPs, community nurses and hospital staff as well as specialist palliative care teams. It aims to provide a checklist for the management of common problems in palliative care, with some information on drug treatment.

  • Source: ruh.nhs.uk
  • Clinical Resource: Handbook
  • Register to Access Content: No

The Palliative Care Handbook

The aim of this resource is to make palliative care understandable for healthcare professionals, using clear logical layout and understandable explanations of how to manage and cope with problems that can be very challenging. It includes sections on dementia, nutrition and prescribing.

  • Source: hospice.org.nz
  • Clinical Resource: Handbook
  • Register to Access Content: No

ABC of palliative care

Principles of palliative care and pain control

The World Health Organisation defines palliative care as “the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems, is paramount.

Difficult pain problems

Roughly 80-90% of pain due to cancer can be relieved relatively simply with oral analgesics and adjuvant drugs in accordance with the World Health Organisation’s guidelines. The remaining 10-20% can be difficult to treat.

Breathlessness, cough, and other respiratory problems

Respiratory problems are common in patients with advanced incurable disease. This article describes palliation of adult patients with malignant disease, but the principles can be applied to many types of non-malignant disease.

Mouth care, skin care, and lymphoedema

Patients’ oral problems can be kept to a minimum by good hydration, brushing the teeth with a fluoride toothpaste twice daily, and daily observation of the oral mucosa.

Nausea, vomiting, and intestinal obstruction

Nausea, vomiting, and retching are common and distressing complaints: surveys have found that 50-60% of patients with advanced cancer suffer from one or more of these.

Anorexia, cachexia, and nutrition

This article covers approaches to cachexia other than treatment of the underlying disease.

Constipation and diarrhoea

Constipation is more common in patients with advanced cancer than in those with other terminal diseases, and many of the associated symptoms may mimic features of the underlying disease.

Depression, anxiety, and confusion

A common mistake is to assume that depression and anxiety represent nothing more than natural and understandable reactions to incurable illness.

HIV infection and AIDS

Currently, the clinical picture is changing through the use of new combinations of antiretroviral drugs, which improve patients’ wellbeing and delay disease progression.

Emergencies

Some acute events in malignancy have to be treated as an emergency if a favourable outcome is to be achieved. As in any emergency, the assessment must be as prompt and complete as possible.

The last 48 hours

During the final 48 hours of life, patients experience increasing weakness and immobility, loss of interest in food and drink, difficulty swallowing, and drowsiness.

  • Source: europepmc.org
  • Clinical Resource: Journal Articles
  • Register to Access Content: No

Guidelines for the Management of Common Symptoms in the Last Few Days of Life
LOROS Hospice

  • Source: loros.co.uk
  • Clinical Resource: Guideline
  • Register to Access Content: No

Syringe Driver Compatibility Guidance

  • Source: bettersafecare.vic.gov.au
  • Clinical Resource: Guidance
  • Register to Access Content: No

 

Resources last checked: 16/09/2021