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Palliativecare - constipation: How long is it before different laxative preparations take effect? Time to wait for laxative effect | Prescribing information | Palliativecare - constipation | CKS | NICE Search CKS… Menu Time to wait for laxative effect Palliativecare - constipation: How long is it before different laxative preparations take effect? Last revised in October 2016 How long is it before different laxative preparations take effect? For information on times for different laxative
Palliativecare - constipation: How do laxatives work? How laxatives work | Prescribing information | Palliativecare - constipation | CKS | NICE Search CKS… Menu How laxatives work Palliativecare - constipation: How do laxatives work? Last revised in October 2016 How do laxatives work? Bulk-forming laxatives (ispaghula husk, methylcellulose, and sterculia) act by retaining fluid within the stool and increasing faecal mass, leading to stimulation of peristalsis. They also have stool-softening
Palliativecare - constipation: Diagnosis of constipation in palliativecare Diagnosis | Diagnosis | Palliativecare - constipation | CKS | NICE Search CKS… Menu Diagnosis Palliativecare - constipation: Diagnosis of constipation in palliativecare Last revised in October 2016 Diagnosis of constipation in palliativecare Suspect constipation when: Stools are hard, uncomfortable, or difficult to pass, and are less frequent than usual; or the person has a sense of incomplete evacuation after (...) , are thrombocytopenic, or who have rectal or anal disease), or on gentle digital examination of the stoma (if the person has a colostomy). 98% of faecal impactions occur in the rectum. Careful examination can usually distinguish a faecal mass from a tumour or cyst: firm pressure exerted by a finger will leave a palpable indentation in hard faeces. Suspect bowel obstruction when any of the following symptoms or signs are present: Absence of passage of flatus per rectum. Colicky, abdominal pain and abdominal
Palliativecare - constipation: Adverse effects of oral laxatives Adverse effects of oral laxatives | Prescribing information | Palliativecare - constipation | CKS | NICE Search CKS… Menu Adverse effects of oral laxatives Palliativecare - constipation: Adverse effects of oral laxatives Last revised in October 2016 Adverse effects of oral laxatives Most adverse effects can be avoided or reduced by increasing the dose of oral laxatives gradually. Advise people to start at the lowest dose
Palliativecare - constipation Palliativecare - constipation | Topics A to Z | CKS | NICE Search CKS… Menu Palliativecare - constipation Palliativecare - constipation Last revised in October 2016 Constipation is defecation that is unsatisfactory because of infrequent stools, difficult stool passage, or seemingly incomplete defecation. Diagnosis Management Prescribing information Background information Palliativecare - constipation: Summary Constipation is defecation that is unsatisfactory (...) because of infrequent stools, difficult stool passage, or seemingly incomplete defecation. Stools are often dry and hard, and may be abnormally large or abnormally small. About 80% of people with cancer will require treatment with laxatives at some time. People receiving palliativecare have multiple causes of constipation, such as: Drugs, for example, opioid analgesics, antimuscarinic drugs, antacids. Secondary effects of disease, for example, dehydration, inadequate dietary fibre, inactivity
Palliativecare - oral: Topical antifungals Topical antifungals | Prescribing information | Palliativecare - oral | CKS | NICE Search CKS… Menu Topical antifungals Palliativecare - oral: Topical antifungals Last revised in October 2018 Topical antifungals Recommended topical antifungal Topical nystatin or topical miconazole are recommended for first-line treatment of oral candida infection. Few trials have compared the use of topical anticandidal treatments in people with cancer (...) in palliativecare [ ]. Nystatin is recommended as it only needs to be prescribed for 7 days and resistance to nystatin is uncommon [ ]. Miconazole also only needs to be prescribed for 7 days. It is an imidazole antifungal which provides a different therapeutic option to nystatin as it belongs to a different antifungal class. However, resistance to miconazole is becoming increasingly common, especially in people who are immunocompromised [ ]. Amphotericin is not recommended as it needs to be prescribed
Palliativecare - oral: Scenario: Oral pain Scenario: Oral pain | Management | Palliativecare - oral | CKS | NICE Search CKS… Menu Scenario: Oral pain Palliativecare - oral: Scenario: Oral pain Last revised in October 2018 Scenario: Oral pain From age 16 years onwards. Topical pain relief Treat the underlying cause of oral pain where possible. If this is not possible or not fully effective, treat pain symptomatically. For mild to moderate oral pain, use topical non-opioid analgesia (...) . For localized pain: Choline salicylate gel — short-lived effect. Excessive use should be avoided because it can lead to ulceration, particularly if the gel is trapped under dentures. Benzydamine spray — relatively short duration of action, and numbness and stinging are sometimes a problem. Lidocaine 5% ointment or 10% spray — duration of action of topical local anaesthetics, such as lidocaine, is relatively short, and these agents will not provide continuous pain relief throughout the day. Care should also
Palliativecare - oral: Scenario: Prevention Scenario: Prevention | Management | Palliativecare - oral | CKS | NICE Search CKS… Menu Scenario: Prevention Palliativecare - oral: Scenario: Prevention Last revised in October 2018 Scenario: Prevention From age 16 years onwards. Self care Brush the teeth twice a day with a soft toothbrush and fluoride-containing toothpaste, and rinse with water, or a fluoride or antiseptic mouthwash. Note: a 'sore mouth' toothpaste or a child's toothpaste (...) an antiseptic mouthwash, such as chlorhexidine. Use chlorhexidine mouthwash if gum disease is diagnosed. For more information on mouthwashes, see . Take adequate fluids. Clean debris from the teeth. Dental floss, or chewing pineapple (contains ananase, which is a cleansing enzyme), fresh or unsweetened, may help to remove debris. The frequency of mouth care should be increased to: Every 2 hours if there is a high risk of oral problems (any persons with advanced disease or neurological impairment
Covid-19 and the role of oxygen in palliativecare at home Covid-19 and the role of oxygen in palliativecare at home - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Covid-19 and the role of oxygen in palliativecare at home May 26, 2020 26 May 2020 Dr Lyn Jenkins, on behalf of Correspondence to: If I were to come down with severe Covid-19 and choose to stay at home rather than go into hospital, would I (...) benefit from receiving oxygen? Among the many questions surrounding palliativecare at home, that’s the one that persistently nags at me. There is that high-flow oxygen in hospital would improve my chances of survival but what about home-delivered oxygen? Does low-flow oxygen through a mask or nasal tubes, or a positive pressure ventilation machine (such as that which relieves breathing problems during sleep), make a difference to survival? I’ve not come across any case studies or random control
Health Sciences, The University of Oxford. Dr Clare Gardiner PhD is a Senior Research Fellow at the Palliative and End of Life Care Studies Group, in the Health Sciences School, The University of Sheffield. SEARCH TERMS Database: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily <1946 to May 06, 2020> Search Strategy: ——————————————————————————– 1 palliativecare/ or palliative medicine/ or palliat*.mp. or hospices/ or terminally ill/ or terminal care (...) The role and response of primary care and community nursing in the delivery of palliativecare in epidemics and pandemics: a rapid review to inform practice and service delivery during the COVID-19 pandemic The role and response of primary care and community nursing in the delivery of palliativecare in epidemics and pandemics: a rapid review to inform practice and service delivery during the COVID-19 pandemic - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes
of palliativecare and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic. J Pain Symptom Manage. 2020. 5. Borasio GD, Gamondi C, Obrist M, Jox R, For The Covid-Task Force Of Palliative C. COVID- 19: decision making and palliativecare. Swiss Med Wkly. 2020;150:w20233. Appendix 1: PubMed search terms: ((palliativecare[MeSH Terms] OR palliat*[title/abstract] OR hospices[MeSH Terms] OR “terminal care”[title/abstract] OR "terminally ill"[title/abstract (...) ])) AND ((2019- nCoV[title/abstract] or nCoV[title/abstract] or covid-19[title/abstract] or covid19[title/abstract] or "covid 19"[title/abstract] OR "coronavirus"[MeSH Terms] OR "coronavirus"[title/abstract])) PubMed search terms: ((palliativecare[MeSH Terms] OR palliat*[title/abstract] OR hospices[MeSH Terms] OR “terminal care”[title/abstract] OR "terminally ill"[title/abstract])) AND ("pandemics"[MeSH Terms] OR "pandemic*"[title/abstract]) Document History Original search 28 March 2020 Review 12 April
Management of people with COVID-19 who are receiving palliativecare Risks of more complex grief and bereavement may be increased due to restrictions on patient contacts during the dying process, social distancing and community isolation, and increased financial and relationships stressors. PP [NSW Health] MANAGEMENT OF PEOPLE WITH COVID- 19 WHO ARE RECEIVING P ALLIA TIVE CARE People requiring palliativecare and COVID- 19 This population includes people with COVID-19 whose prognosis due to co (...) such as communication boards, electronic communication devices). PP [Taskforce] Respiratory distress and a diagnosis of COVID-19 will likely cause high levels of anxiety and distress. There may be worsening of pre- existing mental health conditions. PP [SA Health] Communicate with patients and support their mental wellbeing to help alleviate any anxiety and fear they may have about COVID-19. PP [NICE] COVID-19 limits face-to-face contact, which is an important part of palliativecare. Ensure that regular
Improved Quality of Death and Dying in Care Homes: A PalliativeCare Stepped Wedge Randomized Control Trial in Australia Mortality in care homes is high, but care of dying residents is often suboptimal, and many services do not have easy access to specialist palliativecare. This study examined the impact of providing specialist palliativecare on residents' quality of death and dying.Using a stepped wedge randomized control trial, care homes were randomly assigned to crossover from control (...) to intervention using a random number generator. Analysis used a generalized linear and latent mixed model. The trial was registered with ANZCTR: ACTRN12617000080325.Twelve Australian care homes in Canberra, Australia.A total of 1700 non-respite residents were reviewed from the 12 participating care homes. Of these residents, 537 died and 471 had complete data for analysis. The trial ran between February 2017 and June 2018.PalliativeCare Needs Rounds (hereafter Needs Rounds) are monthly hour-long staff-only
PalliativeCare for Geriatric Trauma Patients, Trauma Center Care and Routine Processes for Care - Evidence-Based Review Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W on 04/05/2019 Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W (...) ,LawrenceLottenberg,MD, CalebMentzer,DO,AnneMosenthal,MD,KaushikMukherjee,MD,MSci,JoshuaNash,DO, BryceRobinson,MD,MS,KristanStaudenmayer,MD,MS,RebeccaWright,PhD, JamesYon,MD,andMarieCrandall,MD,MPH, Jacksonville,Florida BACKGROUND: Despiteanagingpopulationandincreasingnumberofgeriatrictraumapatientsannually,gapsinourunderstandingofbestprac- ticesforgeriatrictraumapatientspersist.Weknowthattraumacentercareimprovesoutcomesforinjuredpatientsgenerally,and palliativecare processes can improve outcomes for disease
Evaluation of a PalliativeCare Program for Nursing Homes in 7 Countries: The PACE Cluster-Randomized Clinical Trial High-quality evidence on how to improve palliativecare in nursing homes is lacking.To investigate the effect of the PalliativeCare for Older People (PACE) Steps to Success Program on resident and staff outcomes.A cluster-randomized clinical trial (2015-2017) in 78 nursing homes in 7 countries comparing PACE Steps to Success Program (intervention) with usual care (control (...) ). Randomization was stratified by country and median number of beds in each country in a 1:1 ratio.The PACE Steps to Success Program is a multicomponent intervention to integrate basic nonspecialist palliativecare in nursing homes. Using a train-the-trainer approach, an external trainer supports staff in nursing homes to introduce a palliativecare approach over the course of 1 year following a 6-steps program. The steps are (1) advance care planning with residents and family, (2) assessment, care planning
Early PalliativeCare Consultation in the Medical ICU: A Cluster Randomized Crossover Trial To assess the impact of early triggered palliativecare consultation on the outcomes of high-risk ICU patients.Single-center cluster randomized crossover trial.Two medical ICUs at Barnes Jewish Hospital.Patients (n = 199) admitted to the medical ICUs from August 2017 to May 2018 with a positive palliativecare screen indicating high risk for morbidity or mortality.The medical ICUs were randomized (...) to intervention or usual care followed by washout and crossover, with independent assignment of patients to each ICU at admission. Intervention arm patients received a palliativecare consultation from an interprofessional team led by board-certified palliativecare providers within 48 hours of ICU admission.Ninety-seven patients (48.7%) were assigned to the intervention and 102 (51.3%) to usual care. Transition to do-not-resuscitate/do-not-intubate occurred earlier and significantly more often
Palliativecare interventions for people with multiple sclerosis. People with multiple sclerosis (MS) have complex symptoms and different types of needs. These demands include how to manage the burden of physical disability as well as how to organise daily life, restructure social roles in the family and at work, preserve personal identity and community roles, keep self-sufficiency in personal care, and how to be part of an integrated care network. Palliativecare teams are trained to keep open (...) with it and their families.To assess the effects (benefits and harms) of palliativecare interventions compared to usual care for people with any form of multiple sclerosis: relapsing-remitting MS (RRMS), secondary-progressive MS (SPMS), primary-progressive MS (PPMS), and progressive-relapsing MS (PRMS) We also aimed to compare the effects of different palliativecare interventions.On 31 October 2018, we conducted a literature search in the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous