Guideline for the management of terminal haemorrhage in palliative care patients with advanced cancer discharged home for end-of-life care

Ubogagu, Edith; Harris, Dylan

doi:10.1136/bmjspcare-2012-000253

Cited by 19 publications

(24 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is a retrospective diagnosis, as patients may experience sentinel bleeds that do not result in terminal haemorrhagic events. The incidence has been reported to vary, with the highest incidence reported in patients with ENT cancers and complications such as carotid blow-out described to be as high as 4% [88,89].…”

Section: Catastrophic Bleedingmentioning

confidence: 99%

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Sood¹,

Mancinetti

Betticher³

et al. 2020

Annals of Medicine and Surgery

View full text Add to dashboard Cite

BackgroundPalliative care patients, those suffering from at least one chronic lifelong medical condition and hospice care patients, those with a life expectancy less than 6 months, are regularly hospitalised in general internal medicine wards. By means of a clinical case, this review aims to equip the internist with an approach to bleeding in this population. Firstly, practical advice on platelet transfusions will be provided. Secondly, the management of bleeding in site-specific situations will be addressed (from the ENT/pulmonary sphere, gastrointestinal - urogenital tract and cutaneous ulcers). Finally, an algorithm pertaining to the management of catastrophic bleeding is proposed.MethodsElectronic databases, including EMBASE, Pubmed, Google Scholar and the Cochrane Library were studied as primary resources, in association with local guidelines, to identify papers exploring platelet transfusions and alternative management of site-specific bleeding in palliative care patients.ResultsHaemorrhagic complications are frequent in palliative care patients in the internal medicine ward. Current guidelines propose a therapeutic-only platelet transfusion policy. Nonetheless, prophylactic and/or therapeutic transfusion remains a physician-dependent decision. Site-specific therapeutic options are based on expert opinion and case reports. While invasive measures may be pertinent in certain situations, their application must be compatible with patient goals. Catastrophic bleeding requires caregivers' comforting presence; pharmacological management is secondary.ConclusionLiterature is lacking regarding management of bleeding in the palliative care population hospitalised in an acute medical setting. Recommendations are of limited quality, the majority based on case reports or expert opinion. Further studies, exploring for example the impact on patient quality of life, are desirable to improve the management of this frequently encountered complication.

show abstract

Section: Catastrophic Bleedingmentioning

confidence: 99%

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Sood¹,

Mancinetti

Betticher³

et al. 2020

Annals of Medicine and Surgery

View full text Add to dashboard Cite

show abstract

“…Terminal haemorrhage is an uncommon but much feared complication, with an incidence of between 3 and 12% (Harris & Noble, 2009), and is commonly associated with head and neck cancer. The literature and evidence for the pharmacological management of this scenario is variable with reports of benzodiazepine, opioid and ketamine use (Harris & Noble, 2009; Ubogagu & Harris, 2012). Supportive measures such as the use of dark towels and the application of pressure, and simply staying with the patient appear to be more important than administering medications (Fig.…”

Section: Anticipatory Prescribing and Symptom Controlmentioning

confidence: 99%

The last 48 hours

Gupta

Sengupta

2014

InnovAiT: Education and inspiration for general practice

View full text Add to dashboard Cite

With an increasing number of patients identifying home as their preferred place of death, GPs are finding themselves at the frontline of providing end-of-life care. Although there is often support available from specialist palliative care teams in the community, GPs are themselves highly capable of providing good general palliative care, commencing advance care planning and supporting patients and their relatives through what can be a difficult time. Early identification of patients approaching the end of their life enables effective planning, prioritisation of care, and making sure that appropriate resources are available, allowing patients to receive care in a timely and coordinated manner.

show abstract

“…1 Although it is relatively rare, it can be profoundly distressing for patients, families, and care providers. This Fast Fact will review the essential preparation and care components in at-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Terminal Hemorrhage Preparation and Management #297

O¹,

Baru²,

Marks³

2015

Journal of Palliative Medicine

View full text Add to dashboard Cite

Guideline for the management of terminal haemorrhage in palliative care patients with advanced cancer discharged home for end-of-life care

Abstract: Terminal haemorrhage is a rare yet highly feared complication of advanced cancer, for which there is a limited evidence base to guide management. The suggested three-step approach to managing this situation gives professionals a logical framework within which to work.

Cited by 19 publications

References 11 publications

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

The last 48 hours

Terminal Hemorrhage Preparation and Management #297

Contact Info

Product

Resources

About