The thoughts and opinions of advanced life support providers in the South African private emergency medical services sector concerning pre-hospital palliative care
type: CreativeWork
description: The World Health Organisation (WHO) defines palliative care as 'an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.' 1 This includes a wide variety of situations such as chronic illness and end-of-life care. 2 Palliative care is usually performed in-hospital. However, emergency medical services (EMS) often encounter patients requiring palliative care as these patients may have acute exacerbations of illness, progress towards end-of-life or require transport to a medical facility. 3-9 Thus, there is a role for palliative care in the pre-hospital setting. EMS providers are uniquely positioned to deliver this care in the pre-hospital setting as they are often the first point of medical contact. 10 This has great potential benefit for patient comfort, early identification and relief of suffering and earlier referral to hospice care. 10, 11 Despite this unique position there is an overall lack of guidance within EMS systems to manage palliative patients. 5, 6, 10 In the United States of America (USA), for example, only 5-6% of EMS systems have protocols for palliative care. 6, 10 In addition, there is no specific pre-hospital emergency care curricula on the subject, resulting in a lack of education and training for EMS providers. 3-5, 12, 13 This may stem from the historical focus of EMS training which primarily involves immediate measures to preserve life or limb until definitive care is reached. 11 This focus has resulted in an EMS ethos of 'saving lives.' 5, 12 Palliative care, on the other hand, is not focussed on 'saving lives', but rather the prevention and relief of suffering. 1 Therefore, palliative care may seem to conflict with emergency care, placing EMS providers in difficult situations when …
abstract: The World Health Organisation (WHO) defines palliative care as 'an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.' 1 This includes a wide variety of situations such as chronic illness and end-of-life care. 2 Palliative care is usually performed in-hospital. However, emergency medical services (EMS) often encounter patients requiring palliative care as these patients may have acute exacerbations of illness, progress towards end-of-life or require transport to a medical facility. 3-9 Thus, there is a role for palliative care in the pre-hospital setting. EMS providers are uniquely positioned to deliver this care in the pre-hospital setting as they are often the first point of medical contact. 10 This has great potential benefit for patient comfort, early identification and relief of suffering and earlier referral to hospice care. 10, 11 Despite this unique position there is an overall lack of guidance within EMS systems to manage palliative patients. 5, 6, 10 In the United States of America (USA), for example, only 5-6% of EMS systems have protocols for palliative care. 6, 10 In addition, there is no specific pre-hospital emergency care curricula on the subject, resulting in a lack of education and training for EMS providers. 3-5, 12, 13 This may stem from the historical focus of EMS training which primarily involves immediate measures to preserve life or limb until definitive care is reached. 11 This focus has resulted in an EMS ethos of 'saving lives.' 5, 12 Palliative care, on the other hand, is not focussed on 'saving lives', but rather the prevention and relief of suffering. 1 Therefore, palliative care may seem to conflict with emergency care, placing EMS providers in difficult situations when …
author: Gage, Caleb Hanson
keywords: Emergency Medicine
date published: 2020
date modified: 2026-07-22T22:22:44Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Division of Emergency Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/32216