Mattresses or Overlays Used in Palliative End-of-Life Care: Clinical Evidence and Guidelines Mattresses or Overlays Used in Palliative End-of-Life Care: Clinical Evidence and Guidelines | CADTH.ca Find the information you need Mattresses or Overlays Used in Palliative End-of-Life Care: Clinical Evidence and Guidelines Mattresses or Overlays Used in Palliative End-of-Life Care: Clinical Evidence and Guidelines Last updated: January 30, 2019 Project Number: RB1304-000 Product Line: Research Type (...) : Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical evidence regarding patient comfort and satisfaction with mattresses or mattress overlays used in palliative end-of-life care? What are the evidence-based guidelines regarding the use of mattresses or mattress overlays in palliative end-of-life care? Key Message One non-randomized study and one evidence-based guideline were identified regarding the use of mattresses in palliative end-of-life care

Pediatric Palliative Care Assessment Tools in the Home-Care Setting: Guidelines Pediatric Palliative Care Assessment Tools in the Home-Care Setting: Guidelines | CADTH.ca Find the information you need Pediatric Palliative Care Assessment Tools in the Home-Care Setting: Guidelines Pediatric Palliative Care Assessment Tools in the Home-Care Setting: Guidelines Last updated: August 2, 2019 Project Number: RB1372-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts (...) Result type: Report Question What are the evidence-based guidelines regarding home-care assessments for pediatric palliative-care patients? Key Message One evidence-based guideline was identified regarding home-care assessments for pediatric palliative-care patients. Files Rapid Response Summary of Abstracts Published : August 2, 2019 Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter:

, future projections and implications for services. BMC Med. 15(1), 102. 4 Bone AE, et al. (2018). What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death. Palliat. Med. 32(2), 329-336. 5 The Academy of Medical Sciences (2018). Multimorbidity: a priority for global health research. https://acmedsci.ac.uk/file-download/82222577 6 Murtagh FE, et al. (2013). How many people need palliative care? A study developing and comparing (...) on the future provision of end-of-life care? Population-based projections of place of death. Palliat. Med. 32(2), 329-336. 10 Barnett K, et al. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380(9836), 37-43. 11 Worldwide Palliative Care Alliance and World Health Organisation (2014). Global Atlas of Palliative Care at the End of Life. https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf 12 Etkind SN, et al

Perinatal Palliative Care Perinatal Palliative Care - ACOG Menu ▼ Perinatal Palliative Care Page Navigation ▼ Number 786 Committee on Obstetric Practice Committee on Ethics The American Academy of Pediatrics and the Society for Maternal-Fetal Medicine endorse this document. This Committee Opinion was developed by the Committee on Obstetric Practice with the assistance of committee member Russell S. Miller, MD and the American Academy of Pediatrics’ liaison member James J. Cummings, MD (...) ; and the Committee on Ethics with the assistance of the American Academy of Pediatrics’ liaison member Robert Macauley, MD and the Society for Maternal-Fetal Medicine’s liaison member Steven J. Ralston, MD, MPH. Perinatal Palliative Care ABSTRACT : Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early

Clinical Practice Guidelines for Quality Palliative Care Clinical Practice Guidelines for Quality Palliative Care | From the American Academy of Pediatrics | Pediatrics '); document.write(''); } function OAS_AD(pos) { if (OAS_version >= 11 && typeof(OAS_RICH)!='undefined') { OAS_RICH(pos); } else { OAS_NORMAL(pos); } } //--> Search for this keyword Source User menu Sections Sign up for highlighting editor-chosen studies with the greatest impact on clinical care. Clinical Practice Guidelines (...) for Quality Palliative Care The American Academy of Pediatrics has endorsed the following publication: National Coalition for Hospice and Palliative Care, National Consensus Project. Clinical Practice Guidelines for Quality Palliative Care . 4th ed. Richmond, VA: National Coalition for Hospice and Palliative Care; 2018. Available at: . All statements of endorsement from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, retired, or revised at or before

Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. The oligometastatic paradigm suggests that some patients with a limited number of metastases might be cured if all lesions are eradicated. Evidence from randomised controlled trials to support this paradigm is scarce. We aimed to assess the effect of stereotactic ablative radiotherapy (SABR) on survival, oncological (...) ), we randomly assigned patients (1:2) to receive either palliative standard of care treatments alone (control group), or standard of care plus SABR to all metastatic lesions (SABR group), using a computer-generated randomisation list with permuted blocks of nine. Neither patients nor physicians were masked to treatment allocation. The primary endpoint was overall survival. We used a randomised phase 2 screening design with a two-sided α of 0·20 (wherein p<0·20 designates a positive trial). All

Would You Refer This Patient With Cancer to a Palliative Care Specialist?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. In 2016, the American Society of Clinical Oncology published a guideline recommending that all patients with advanced cancer be referred to palliative care providers. This recommendation was based on a series of trials showing that palliative care, when added to standard oncology treatment, improves outcomes, including quality of life. Here, 2 oncologists (...) , 1 of whom is also a palliative care specialist, debate the guideline and discuss how best to care for a 71-year-old woman with metastatic neuroendocrine carcinoma who has a short life expectancy but feels well and has no symptoms related to her cancer or chemotherapy.

Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial Malignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.We performed a multicentre, randomised, parallel group controlled trial comparing (...) early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited.review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30.change in EORTC C30 Global Health Status 12 weeks after

Palliative care - oral: Metronidazole Metronidazole | Prescribing information | Palliative care - oral | CKS | NICE Search CKS… Menu Metronidazole Palliative care - oral: Metronidazole Last revised in October 2018 Metronidazole Prescribing metronidazole Common adverse effects include a metallic taste and gastrointestinal irritation (in particular nausea and vomiting). These are more common at higher doses. Severe bullous skin reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal

Palliative care - oral: Investigations Investigations | Diagnosis | Palliative care - oral | CKS | NICE Search CKS… Menu Investigations Palliative care - oral: Investigations Last revised in October 2018 Investigations The cause of most oral problems can usually be diagnosed on the basis of clinical features alone, and investigations are rarely required. Check the full blood count if neutropenia is suspected. A neutrophil count less than 0.1 x 10 9 cells/L (less than 100 cells/mm 3 ) is often (...) or recurrent oral candidiasis then species typing and sensitivity testing is warranted. Basis for recommendation This recommendation is based on accepted standard practice, and expert opinion in the Oxford textbook of palliative medicine [ ], a textbook of oral health [ ], and a textbook of oral care in advanced disease [ ]. © .

Palliative care - oral: History History | Diagnosis | Palliative care - oral | CKS | NICE Search CKS… Menu History Palliative care - oral: History Last revised in October 2018 History Enquiry into symptoms and problems with the oral cavity should be part of a full history and examination that includes physical, psychological, social, and spiritual issues: Enquire about dry mouth, oral pain, halitosis, alteration in taste, excessive salivation, bad breath, difficulty chewing, difficulty

Palliative care - oral: Corticosteroids Corticosteroids | Prescribing information | Palliative care - oral | CKS | NICE Search CKS… Menu Corticosteroids Palliative care - oral: Corticosteroids Last revised in October 2018 Corticosteroids As corticosteroid use for aphthous ulcers is short-term, potential problems often associated with corticosteroid use (for example osteoporosis) are not relevant. Beclometasone spray or betamethasone soluble tablets are more potent than hydrocortisone lozenges

Palliative care - oral: Examination Examination | Diagnosis | Palliative care - oral | CKS | NICE Search CKS… Menu Examination Palliative care - oral: Examination Last revised in October 2018 Examination The oral cavity examination should be part of a full examination of the person. Look for signs of dehydration and mouth breathing. Examine the mouth for evidence of: Dryness. Ulceration and vesicles (see ). Vesicles are very rarely see in the mouth as they rapidly burst. Erythema. White

Palliative care - oral: Chlorhexidine Chlorhexidine | Prescribing information | Palliative care - oral | CKS | NICE Search CKS… Menu Chlorhexidine Palliative care - oral: Chlorhexidine Last revised in October 2018 Chlorhexidine Chlorhexidine is the most effective antiseptic gel/mouthwash for reducing plaque, gingivitis, and gingival bleeding [ ; ]. In the UK, products available for the prevention and treatment of gingivitis include chlorhexidine gluconate mouthwash (0.12% and 0.2%), spray (0.2

Palliative care - oral: Antivirals Antivirals | Prescribing information | Palliative care - oral | CKS | NICE Search CKS… Menu Antivirals Palliative care - oral: Antivirals Last revised in October 2018 Antivirals Recommended antivirals Topical aciclovir and topical penciclovir are recommended in immunocompetent people who are in the early stages of an uncomplicated herpes simplex infection in the locality of the lips. Oral aciclovir is recommended in: Immunocompetent people who

Palliative care - cough: Scenario: COVID-19 Management Scenario: COVID-19 | Management | Palliative care - cough | CKS | NICE Search CKS… Menu Scenario: COVID-19 Palliative care - cough: Scenario: COVID-19 Management Last revised in April 2020 Scenario: COVID-19 Management From birth onwards. How should my management vary when considering the possibility of COVID-19? Be aware that older people or those with comorbidities, frailty, impaired immunity or a reduced ability to cough and clear (...) issuing an 'acute' prescription with a limited supply. Advise the person of the risks of constipation and consider prescribing a regular stimulant laxative. Avoid cough suppressants in people who suffer from chronic bronchitis and bronchiectasis as this can cause sputum retention. Seek specialist advice for people aged under 18 years. Basis for recommendation These recommendations are based on the National Institute for Health and Care Excellence (NICE) COVID-19 rapid guideline: managing symptoms

Palliative care - cough: Pholcodine linctus BP Pholcodine linctus BP | Prescribing information | Palliative care - cough | CKS | NICE Search CKS… Menu Pholcodine linctus BP Palliative care - cough: Pholcodine linctus BP Last revised in April 2020 Pholcodine linctus BP If the person is already taking a strong opioid such as morphine, do not try a weak opioid such as pholcodine. Instead an 'as required' dose of morphine solution should be used to relieve cough. Pholcodine Linctus BP 5 to 10 mg

Palliative care - cough: Scenario: Assessment Scenario: Assessment | Management | Palliative care - cough | CKS | NICE Search CKS… Menu Scenario: Assessment Palliative care - cough: Scenario: Assessment Last revised in April 2020 Scenario: Assessment From age 16 years onwards. What should I ask about the cough? Ask about the: Impact on the person's quality of life. Severity, time of onset, and duration of the cough. Pattern and character of the cough, for example: Dry cough, persisting over (...) — large amounts (> 100 mL per day) are produced by people with bronchorrhoea, which can occur as a result of bronchiolo-alveolar cancer, asthma, or tuberculosis. Blood — haemoptysis from tumour, or tumour erosion. Dyspnoea — effusion, lung collapse, lymphangitis carcinomatosa. For more information on causes and management of dyspnoea, see the CKS topic on . Basis for recommendation These recommendations are based on expert opinion from palliative care and medical literature developed from clinical

Palliative care - cough: Nebulized sodium chloride Nebulized sodium chloride | Prescribing information | Palliative care - cough | CKS | NICE Search CKS… Menu Nebulized sodium chloride Palliative care - cough: Nebulized sodium chloride Last revised in April 2020 Nebulized sodium chloride When nebulized 0.9% saline solution is used to ease cough associated with tenacious secretions [ ; ; ]: Initially use 2.5 mL to 5 mL four times a day as needed and before physiotherapy [ ]. If greater

Palliative care - cough: Mucolytics Mucolytics | Prescribing information | Palliative care - cough | CKS | NICE Search CKS… Menu Mucolytics Palliative care - cough: Mucolytics Last revised in April 2020 Mucolytics Carbocisteine and mecysteine hydrochloride are options to reduce the viscosity of the secretions. If a palliative care patient does not demonstrate any convincing benefit after a week or two of using a mucolytic, then use of a mucolytic should be discontinued. For carbocisteine