[Palliative Patients and Prehospital Emergency Medicine - Which Aspects Should the Prehospital Emergency Physician Know?]

Emergency medical care indications have changed in Germany in recent years. Emergency interventions in elder people and nursing homes, which used to be an exceptional indication, have now become a standard intervention and one of the main tasks of emergency medical care in Germany. Emergency care for the elderly and people with life-threatening illnesses has increasingly become the focus of modern emergency medicine. Emergency care is increasingly confronted with patients in the palliative stage of illness, with special treatment needs and with end-of-life decisions. The rapidity of these changes in emergency care has not yet been adequately addressed through appropriate training and the expansion of emergency medical and legal knowledge. In palliative care, too, developments and their implementation in practice need to be optimized. Since 2007, for example, there has been a legal entitlement to specialized outpatient palliative care for patients and their families, but is not yet sufficiently available and applicable on a broad basis (according to §§ 37b and 132d of the German Social Code, Book V). For this reason, decisions that needed to be made in anticipation of palliative care continue to be shifted to preclinical emergency care and subsequently to hospitals. The aim of this article is to explain the special features of "palliative emergencies" and to give recommendations for emergency physicians in order to provide excellent therapeutic care for people with life-limiting illnesses.