It is better to be prepared in anticipation to support calm management in the event of their occurrence, than to be unprepared. Ensure that family and staff know how to access care including 24hr advice. Ensure that you reassess the situation after an agreed time period, listening to the family and staffs concerns. Communicate well between professionals and family, ensuring clear documentation of symptom progression and management. In all of your assessments: Ensure that you have time to adequately listen and assess Take each decision with adequate reflection upon the factors involved Discuss regularly with colleagues be afraid to say that you know and be willing to seek Don’t don’t advice from others In terms of treatment: Keep treatment as simple as possible Stick to one drug per symptom where possible Involve the child & family in decisions re treatment choices with oral preparations where possible Manage Plan for anticipated symptoms Listen to the child & account family’s Ensure management is reviewed in an agreed manner Consider the use of a syringe pump if the child is: No longer able to absorb oral medication Vomiting Having difficulty swallowing and has no NG tube/gastrostomy Is not fully conscious Remember to check compatibility of any drugs in a syringe pump and never put more than three drugs in any one pump. For the oncology/haematology children it is useful to agree a protocol for the administration of blood products support, before a crisis is reached. This should be based on the instructions of the child’s consultant. Regularly review the overall medications being given. Do all remain necessary? Consider rationalising drug use, especially in the final days.
It is better to be prepared in anticipation to support calm management in the event of their occurrence, than to be unprepared. Ensure that family and staff know how to access care including 24hr advice. Ensure that you reassess the situation after an agreed time period, listening to the family and staffs concerns. Communicate well between professionals and family, ensuring clear documentation of symptom progression and management. In all of your assessments: Ensure that you have time to adequately listen and assess Take each decision with adequate reflection upon the factors involved Discuss regularly with colleagues Don’t be afraid to say that you don’t know and be willing to seek advice from others In terms of treatment: Keep treatment as simple as possible Stick to one drug per symptom where possible Involve the child & family in decisions re treatment choices Manage with oral preparations where possible Plan for anticipated symptoms Listen to the child & family’s account Ensure management is reviewed in an agreed manner Consider the use of a syringe pump if the child is: No longer able to absorb oral medication Vomiting Having difficulty swallowing and has no NG tube/gastrostomy Is not fully conscious Remember to check compatibility of any drugs in a syringe pump and never put more than three drugs in any one pump. For the oncology/haematology children it is useful to agree a protocol for the administration of blood products support, before a crisis is reached. This should be based on the instructions of the child’s consultant. Regularly review the overall medications being given. Do all remain necessary? Consider rationalising drug use, especially in the final days.
ExRes-West-Midlands_7-Chapter-2-Planning-for-Palliative-Care.docx