9041 - Palliative Care Not Just opiates Dr Bruce Davies...

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Palliative Care Not Just opiates Dr Bruce Davies www.bradfordvts.co.uk
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Introduction “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. The goal of palliative care is the achievement of the best quality of life for patients and their families” WHO
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Introduction Multidisciplinary. Doctors get stuck on the prescribing of drugs which is only a small part.
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17% cared for in Hospices / Hospitals(55% of deaths) 83% cared for at home. (Deaths=45%) Average of 9 home visits by GPs in last month of life.
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Inpatient units 223 Beds 3253 Day units 234 St Christopher’s started in 1967 Most provided by GPs About 45% of “expected” deaths occur at home
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Principles Analgesic ladder Not Just MST ! Total pain relief needs attention to all aspects of pain
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Total Pain Physical Pain Other symptoms Iatrogenic Anxiety Anger Depression
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Orchestration The job par excellence of the GP. Team building Patients and carers need consistency in advice etc
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Skin Etc Mouth care Pressure sores Malignant ulcers Lymphoedema
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Pain Problems Route of administration Non drug methods Neuropathic pain Bone pain Incident pain Visceral pain Anaesthetic techniques
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Respiratory Symptoms Breathlessness Cough Haemoptysis Stridor Pleural pain
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GI Problems Nausea and vomiting Obstruction Constipation Anorexia Cachexia Diarrhoea
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This note was uploaded on 02/23/2012 for the course PHARM 290 taught by Professor Staff during the Fall '10 term at Rutgers.

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9041 - Palliative Care Not Just opiates Dr Bruce Davies...

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