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Palliative Care
Fast Facts and Concepts provide concise, practical, peer-reviewed, and evidence-based summaries on key topics important to clinicians and trainees caring for patients facing life-limiting illnesses.
Fast Facts are designed to be easily accessible and clinically relevant monographs on palliative care topics. They are intended to be quick teaching tools for bedside rounds, as well as self-study material for health care professional trainees and clinicians who work with patients with life-limiting illnesses.
 Source: eperc.mcw.edu |
| Resource Type: Summaries |
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| Resource Last Checked: 15/03/13 |
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Palliative Care Tips
"How to" Practical Suggestions for Common Problems in the Terminally Ill
Primarily used to educate any person who provides clinical care for Palliative Care patients
| Source: palliative.org |
| Resource Type: Tips |
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| Resource Last Checked: 15/03/13 |
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Welcome to the Cumbria Palliative Care website, an online palliative care education and information resource.
Through this website we aim to offer information, advice and support in palliative care for both health care professionals and members of the public that is tailored to meet their needs.
| Source: gp-palliativecare.co.uk |
| Resource Type: Various |
| Register to Access Content: No |
| Resource Last Checked: 15/03/13 |
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These palliative care tools were developed or adapted by Promoting Excellence in End-of-Life Care demonstration projects and national workgroups. Click on any of the categories below to run a current search.
Clinical Care Tools
Evaluation Tools
Educational Tools
Organizational Tools
| Source: promotingexcellence.org |
| Resource Type: Tools |
| Register to Access Content: No |
| Resource Last Checked: 15/03/13 |
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Under each of the sections below is a selection of measurement and evaluation tools for conducting palliative care research. Many of these tools are copyrighted and professionals should site sources and register, if applicable, when using the material.
Pain and Symptom Management
Functional Status
Psychosocial Care
Caregiver Assessment
Quality of Life
| Source: npcrc.org |
| Resource Type: Tools |
| Register to Access Content: Yes - some of these tools require registration |
| Resource Last Checked: 15/03/13 |
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The Palliative Care Guidelines reflect a consensus of opinion about good practice in the management of adult patients with a life limiting illness. They have been developed by a multidisciplinary group of professionals working in the community, hospital and specialist palliative care services and approved by local Formulary and Clinical Policy Committees. There is a separate section covering paediatric palliative care on this website.
Palliative Care Guidelines
Symptom control
Pain management
Subcutaneous medication
Medication issues
Non-Cancer palliative care
Other issues
Patient Information
Resources for professionals
| Source: palliativecareguidelines.scot.nhs.uk |
| Resource Type: Guidelines |
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| Resource Last Checked: 15/03/13 |
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Pain & Symptom Control Guidelines
Palliative Care
These guidelines have been adapted from the Greater Manchester and Cheshire Cancer Network guidelines for pain and symptom control in Palliative Care. The guidelines are broken down into sections which are specific to areas of palliative care.
| Source: boltonccg.nhs.uk |
| Resource Type: Guideline |
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| Resource Last Checked: 16/04/13 |
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This leaflet contains general guidelines on prescribing in Palliative Care.
Contents:
- Pain
- Constipation
- Nausea & Vomiting
- Mouth Care
- Dyspnoea
- Terminal Care
| Source: wales.nhs.uk |
| Resource Type: Leaflet |
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| Resource Last Checked: 15/03/13 |
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St Benedict's Hospice
Clinical Guidelines
The team of st benedict’s have produced a list of clinical guidelines about common problems that you may experience.
Palliative Care Emergencies
The following documents provide guidance on how to manage palliative care emergencies
Syringe Drivers
Many symptoms are controlled using syringe drivers. The following documents will help you in setting up and managing syringe drivers.
| Source: hospice.co.uk |
| Resource Type: Various |
| Register to Access Content: No |
| Resource Last Checked: 15/03/13 |
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ABC of palliative care
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.
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.
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.
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 retching are common and distressing complaints: surveys have found that 50-60% of patients with advanced cancer suffer from one or more of these.
This article covers approaches to cachexia other than treatment of the underlying disease.
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.
A common mistake is to assume that depression and anxiety represent nothing more than natural and understandable reactions to incurable illness.
Currently, the clinical picture is changing through the use of new combinations of antiretroviral drugs, which improve patients' wellbeing and delay disease progression.
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.
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 |
| Resource Type: Journal Articles |
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| Resource Last Checked: 15/03/13 |
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Helping others to learn about caring for people with advanced disease has always been a fundamental part of effective palliative care. The aim is to resource existing professionals, carers and teams with the knowledge and skills needed in their daily work.
The CLIP worksheets grew from the idea of a "coffee update". The principle was to develop a flexible learning material that could be used over a coffee break, but could also be used in a variety of settings.
All the CLIP worksheets have been adapted as online tutorials, with permission, by Help the Hospices from Helping the Patient with Advanced Disease: a Workbook, Regnard C, ed. Radcliffe Medical Press 2004.
| Source: helpthehospices.org.uk |
| Resource Type: CE / CPD / Learning |
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| Resource Last Checked: 15/03/13 |
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The oral route of administration is preferable. However when the parenteral route is required, the subcutaneous route is preferred. Drugs may be given as infusions over 24 hours or as bolus doses. The combination of drugs for subcutaneous infusions must be checked for compatibility prior to prescription and administration.
The drug compatibilities in this guideline are collated from published literature. The criteria for the selection of compatibilities into this guideline included at least two of the following
| Source: gha.net.au |
| Resource Type: Guideline |
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| Resource Last Checked: 18/02/13 |
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Breakthrough pain in cancer – information for medical professionals
Breakthrough pain is a common problem in cancer patients, and is associated with significant morbidity in this group of patients. However, the condition is not well understood by many healthcare professionals, and, as a result, the condition is not well managed in many cancer patients.
The main objective of this website is to provide a definitive source of information about breakthrough cancer pain for healthcare professionals. The website will be updated on a regular basis, with particular emphasis on highlighting new research findings. The website will have an interactive element, and healthcare professionals are encouraged to submit comments about the current content, suggestions about future content, and questions for the editorial board.
| Source: breakthroughcancerpain.org |
| Resource Type: Various |
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| Resource Last Checked: 15/03/13 |
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Opioid Conversion Chart
The dosage of a new opioid is based on several factors including the available equi-analgesic dose data, the clinical condition of the patient, concurrent medications and patient safety. It is recommended that the new dose should be reduced by 30-50% to allow for incomplete cross-tolerance. The patient should be monitored closely until stable when switching opioid medications.
| Source: olh.ie |
| Resource Type: Chart |
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| Resource Last Checked: 04/04/13 |
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Opiate Conversion Doses
Note: these conversions are provided only as an approximate guide to equivalences and individual patient variability needs to be considered when
switching from one opioid to another.
| Source: wales.nhs.uk |
| Resource Type: Table |
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| Resource Last Checked: 25/02/13 |
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What are the equivalent doses of oral morphine to other oral opioids when used as analgesics in adult palliative care?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals
Morphine is generally the strong opioid of choice and a common question is how to convert a dose of another opioid to morphine or vice versa.
| Source: evidence.nhs.uk |
| Resource Type: Medicines Question and Answer |
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| Resource Last Checked: 04/04/13 |
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How should conversion from oral morphine to fentanyl patches be carried out?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals
Fentanyl patches are an effective alternative to oral morphine and a common question is how to change a patient from oral morphine to a fentanyl patch.
| Source: evidence.nhs.uk |
| Resource Type: Medicines Question and Answer |
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| Resource Last Checked: 04/04/13 |
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Question: How many transdermal fentanyl patches can be applied at one time?
There are two brands of matrix transdermal fentanyl patches currently available in Ireland, Durogesic DTrans® transdermal patches and Matrifen® transdermal patches.
| Source: olh.ie |
| Resource Type: Question and Summary |
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| Resource Last Checked: 04/04/13 |
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Question: Can transdermal fentanyl patches be changed every 48 hours instead of every 72 hours?
In the majority of patients, analgesia is maintained for the duration of the recommended 72 hours that the patch is in situ.
| Source: olh.ie |
| Resource Type: Question and Summary |
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| Resource Last Checked: 04/04/13 |
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