Palliative care in humanitarian crises: a review of the literature

Nouvet, Élysée; Sivaram, Mollie; Bezanson, Kevin; Krishnaraj, Gautham; Hunt, Matthew; Laat, Sonya de; Sanger, Stephanie; Banfield, Laura; Rodriguez, Pedro Favila Escobio; Schwartz, Lisa

doi:10.1186/s41018-018-0033-8

Cited by 74 publications

(109 citation statements)

References 60 publications

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“…16,17 Indeed, there is no evidence to support any specific model of palliative care in these circumstances. 18 Palliative care in the context of a pandemic…”

Section: Lessons From Previous Pandemicsmentioning

confidence: 99%

Palliative care in the context of a pandemic: similar but different

Davies

Hayes

2020

Clinical Medicine

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Palliative care is an important component of the medical response to pandemics and other health emergencies. The principles of palliative care do not change, but the practice of palliative care has to change as a result of factors such as greater demand and infection control measures. This article makes suggestions for palliative care provision during a pandemic (in developed countries), based on a limited review of the literature and personal experience of the ongoing pandemic (COVID-19 infection).

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“…16,17 Indeed, there is no evidence to support any specific model of palliative care in these circumstances. 18 Palliative care in the context of a pandemic…”

Section: Lessons From Previous Pandemicsmentioning

confidence: 99%

Palliative care in the context of a pandemic: similar but different

Davies

Hayes

2020

Clinical Medicine

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“…During the surge, there can be a transition to the consultative model with explicit triggers to ensure timely clinical service provision (Table 1). Ultimately, dynamic changes in workflow and clinical load, as well as the unique challenges of this new viral infection, require flexibility and improvisation to provide a commensurate supportive care response [53]. Further research will help identify the most effective model for such a response.…”

Section: Supportive Care Interventionsmentioning

confidence: 99%

Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care

Anantham¹,

Chai-Lim²,

Zhou³

et al. 2020

j intensive care

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Triage becomes necessary when demand for intensive care unit (ICU) resources exceeds supply. Without triage, there is a risk that patients will be admitted to the ICU in the sequence that they present, disadvantaging those who either present later or have poorer access to healthcare. Moreover, if the patients with the best prognosis are not allocated life support, there is the possibility that overall mortality will increase. Before formulating criteria, principles such as maximizing lives saved and fairness ought to have been agreed upon to guide decision-making. The triage process is subdivided into three parts, i.e., having explicit inclusion/exclusion criteria for ICU admission, prioritization of patients for allocation to available beds, and periodic reassessment of all patients already admitted to the ICU. Multidimensional criteria offer more holistic prognostication than only using age cutoffs. Appointed triage officers should also be enabled to make data-driven decisions. However, the process does not merely end with an allocation decision being made. Any decision has to be sensitively and transparently communicated to the patient and family. With infection control measures, there are challenges in managing communication and the psychosocial distress of dying alone. Therefore, explicit video call protocols and social services expertise will be necessary to mitigate these challenges. Besides symptom management and psychosocial management, supportive care teams play an integral role in coordination of complex cases. This scoping review found support for the three-pronged, triage-communicationsupportive care approach to facilitate the smooth operationalization of the triage process in a pandemic.

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“…In the past few years, there has been an emphasis on providing palliative care in humanitarian emergencies and crises. While the focus is rightly on saving lives, there is also an ethical imperative to prevent and relieve pain and suffering; therefore, palliative care should be integrated into our response [26,27]. Various papers, both oral and posters, reported on work being undertaken with South Sudanese refugees living in the settlements in Adjumani, Northern Uganda.…”

Section: Provision Of Cancer and Palliative Care To 'Hard To Reach' Amentioning

confidence: 99%

Towards universal coverage—highlights from the 2nd Uganda Conference on Cancer and Palliative Care, 5–6 September 2019, Kampala, Uganda

Downing

Niyonzima

Guma³

et al. 2019

ecancer

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The 2nd Uganda Conference on Cancer and Palliative Care was held in September 2019 in Kampala, Uganda under the theme: Towards Universal Coverage. It was hosted by the Uganda Cancer Institute and the Palliative Care Association of Uganda (PCAU). The conference brought together 350 delegates from eight countries. Key themes from the conference included: universal health coverage (UHC), service provision and public health; resources for achieving UHC; capacity building; human rights and engagement on the implementation of the recommendations made by the Uganda Human Rights Commission; provision of cancer and palliative care to 'hard to reach' and 'vulnerable' groups; paediatrics; health promotion and prevention; policy and advocacy and digital technology. The conference also gave opportunity to celebrate the 20th Anniversary of the work of PCAU, with a celebration dinner attended by the Minister of Health. The past few years have seen significant developments in both cancer and palliative care in Uganda, and this was evident in the presentations, and the way that provision has changed and improved since the first cancer and palliative care conference in 2017. Emphasis on UHC, along with the support of government and other stakeholders, is important in the ongoing development of cancer and palliative care services in Uganda.

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Palliative care in humanitarian crises: a review of the literature

Cited by 74 publications

References 60 publications

Palliative care in the context of a pandemic: similar but different

Palliative care in the context of a pandemic: similar but different

Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care

Towards universal coverage—highlights from the 2nd Uganda Conference on Cancer and Palliative Care, 5–6 September 2019, Kampala, Uganda

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