Primary Care - Serious Complications and Emergencies
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Serious Complications and Emergencies

Serious complications and emergencies in palliative care occur when there is a sudden and life-threatening change in a patient’s condition. This may occur unexpectedly or may be predicted by the nature and progression of the patient’s illness.

Some of the more common and serious emergencies will be explored further in this section.

Airway obstruction

Airway obstruction
CareSearch
This website describes the clinical evidence supporting management of airway obstruction in palliative care.
 
Respiratory symptoms and managing secretions in end of life care
The Palliative Care Bridge
This video Dr Caitlin Sheehan discusses respiratory symptoms at the end of life.

Bleeding and haemorrhage

Major bleeding
CareSearch
This website describes the clinical evidence supporting management of major bleeding in palliative care.

Bowel obstruction

Bowel obstruction in palliative care is due to a partial or complete occlusion of the bowel lumen, preventing or delaying the movement of intestinal contents. This can have an acute or sub-acute onset. Causes may include abdominal malignancy, intra-abdominal carcinomatosis, post-surgical adhesions, and intestinal motility disorders. Faecal impaction can result in similar symptoms and should be excluded.

Active treatment of bowel obstruction can include medical or surgical options depending on the patient’s clinical condition, their disease status, co-morbidities and function. Some patients may benefit from surgical intervention, for example if their bowel obstruction is localised and they are well enough to benefit from surgery. Consult or refer to specialist palliative care services as required.

Bowel obstruction
CareSearch

This website describes the clinical evidence supporting management of bowel obstruction in palliative care.

 
Bowel care and intestinal obstruction in end of life care
The Palliative Care Bridge

This interview with Dr Bridget Johnson provides an overview of the causes and management of constipation and bowel obstruction and the importance of differentiating between the two.

Seizures

Seizures
CareSearch
This website describes the clinical evidence supporting management of seizures in palliative care.

Spinal cord compression

Spinal cord compression is a palliative care emergency. It can present with neurologic signs that are patchy and atypical, including neuropathic pain, sensation changes, weakness, numbness, difficulty with micturition and defecation and changes in tone/reflexes. If suspected, refer immediately to hospital for an urgent MRI, unless death is expected or treatment not indicated.

Spinal cord compression
CareSearch
This website describes clinical evidence on management of spinal cord compression in palliative care.

Page updated 29 March 2018