Emergencies in palliative care

This chapter covers the common oncological emergencies, including neutropenic sepsis, spinal cord compression, superior vena cava obstruction, hypercalcaemia, and haemorrhage. In most medical specialties, emergencies are those situations which, if left untreated, will immediately threaten life. In palliative care, where death is an expected outcome, emergencies are those conditions which, if left untreated, will seriously threaten the quality of remaining life. While this chapter focuses on the common oncological emergencies in palliative practice, emergencies may include a wider range of issues, such as the following: emergency discharge so a patient’s wish to die at home can be met; emotional emergencies, with high levels of expressed anxiety; spiritual/existential/social emergencies, with pressure to ‘sort things out’ before it is too late; pain crisis or other unrelieved symptoms. It is important to have a clear understanding of emergencies in palliative care, as their timely management is critical. A crisis situation filled with anxiety may be transformed to an atmosphere of comfort and well-being by pre-decided standardized team responses that demonstrate clarity and decisiveness to the patient and their family.