The Role of Palliative Care in Burns: A Scoping Review

Bayuo, Jonathan; Bristowe, Katherine; Harding, Richard; Agyei, Frank Bediako; Agbeko, Anita Eseenam; Agbenorku, Pius; Baffour, Prince Kyei; Allotey, Gabriel; Hoyte-Williams, Paa Ekow

doi:10.1016/j.jpainsymman.2019.11.006

Cited by 26 publications

(34 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 Although conceptually different, palliative care is sometimes used interchangeably with EOL care, 5 particularly in trauma care. 6,7 The importance of providing high-quality EOL care is well documented and recent studies have highlighted the need for such service across varied patient population, including the ED. 1,[8][9][10] Palliative/ EOL care does not seek to only relieve physical symptoms, but also, to respond to the psychosocial and spiritual needs of patients and their families to attain a dignified death and offer bereavement/ post-bereavement support to families 11 and healthcare staff.…”

Section: Introductionmentioning

confidence: 99%

“Resuscitate and Push”: End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Objective Care in the emergency department focuses significantly on delivering lifesaving/ life-sustaining clinical actions, often with limited attention to health-related suffering even at the end-of-life. How healthcare staff experience and navigate through the end-of-life phase remains minimally explored. Thus, this study aimed to uncover the lived experiences of emergency department staff at the end-of-life. Methods van Manen’s hermeneutic phenomenological approach was used. Nineteen healthcare staff were purposively recruited and interviewed. Interviews were audio-taped, transcribed verbatim, and thematic categories formulated. The existential lifeworld themes (corporeality, relationality, spatiality, and temporality) were used as heuristic guides for reflecting and organizing the lived experiences of participants. Results The overarching category, ‘ resuscitate and push’, was captured as corporeality (resisting death and dying); relationality (connectedness to the body of the patient; and lacking support for family and self); spatiality (navigating through a liminal space and lack of privacy for patients); and temporality (having limited to no time for end-of-life care and grieving). The end-of-life space was unpleasant. Although participants experienced helplessness and feelings of failure, support systems to help them to navigate through these emotions were lacking. Grief was experienced covertly and concealed by the entry of a new patient. Conclusion End-of-life in the emergency department is poorly defined. In addition to shifting from the traditional emergency care model to support the streamlining of palliative care in the department, staff will require support with navigating through the liminal space, managing their grief, and developing a better working relationship with patients/ families.

show abstract

Section: Introductionmentioning

confidence: 99%

“Resuscitate and Push”: End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Se debe tener claro que cada fase de la quemadura incide de forma distinta en la sensibilización a los analgésicos, aparte que puede aumentar si el paciente desarrolla tolerancia a largo plazo (2). Cuando se realizan desbridamientos enzimáticos se debe tener en cuenta que el proceso es extremadamente doloroso, por ende, se suelen aplicar protocolos de opioides a dosis elevadas (10).…”

Section: Opioidesunclassified

Analgesia en el paciente quemado.

Portuguez¹,

Vega

2022

View full text Add to dashboard Cite

Una parte fundamental en el manejo del paciente quemado es el control del dolor por medio de analgesia correcta, conocer el tipo de dolor y la fase en que se encuentra el paciente es necesario para la elección del medicamento, donde el pilar del tratamiento suelen ser un opioide, actualmente la terapia debe ser multimodal con el objetivo de limitar los requerimientos de los opioides y así evitar dos fenómenos de importante conocimiento como la tolerancia y la hiperalgesia inducida por opioides, una tratamiento multimodal limita la aparición de efectos secundarios en estos pacientes. Aparte de eso, las estrategias no farmacológicas son relevantes para un manejo a largo plazo de estos individuos. Un control adecuado influye positivamente en la cicatrización y en la calidad de vida de estos pacientes. Un mal control del dolor no solo exacerba el evento agudo, sino que aumenta las morbilidades que se desarrollan de forma segundaria como la ansiedad y el trastorno de estrés postraumático.

show abstract

“…[5][6][7] Death in the burn unit can be classified as early (within 24-72 hours post-admission) or late (death following a period of active treatment). 8 Withholding active treatment for persons in the former category, if ascertained early, can lead to the timely commencement of comfort care within the limited period of hospitalisation. Persons in the late death category may survive the injury for a period before active therapy is withdrawn.…”

Section: Introductionmentioning

confidence: 99%

“…10 Thus, although palliative care differs from end of life care, the limited timeframe which may run the short duration of the burn injury trajectory or limited to the final days following withdrawal of active treatment suggests that both may overlap in burns management. 8–10…”

Section: Introductionmentioning

confidence: 99%

“Hanging in a balance”: A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Although the culture in burns/critical care units is gradually evolving to support the delivery of palliative/end of life care, how clinicians experience the end of life phase in the burn unit remains minimally explored with a general lack of guidelines to support them. Aim: To explore the end of life care experiences of burn care staff and ascertain how their experiences can facilitate the development of clinical guidelines. Design: Interpretive-descriptive qualitative approach with a sequential two phased multiple data collection strategies was employed (face to face semi-structured in-depth interviews and follow-up consultative meeting). Thematic analysis was used to analyze the data. Setting/participants: The study was undertaken in a large teaching hospital in Ghana. Twenty burn care staff who had a minimum of 6 months working experience completed the interviews and 22 practitioners participated in the consultative meeting. Results: Experiences of burn care staff are complex with four themes emerging: (1) evaluating injury severity and prognostication, (2) nature of existing system of care, (3) perceived patient needs, and (4) considerations for palliative care in burns. Guidelines in this regard should focus on facilitating communication between the patient and family and staff, holistic symptom management at the end of life, and post-bereavement support for family members and burn care practitioners. Conclusions: The end of life period in the burn unit is poorly defined coupled with prognostic uncertainty. Collaborative model of practice and further training are required to support the integration of palliative care in the burn unit.

show abstract

The Role of Palliative Care in Burns: A Scoping Review

Cited by 26 publications

References 61 publications

“Resuscitate and Push”: End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study

“Resuscitate and Push”: End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study

Analgesia en el paciente quemado.

“Hanging in a balance”: A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit

Contact Info

Product

Resources

About