Paramedics and clinicians from Canada, the Czech Republic and the United Kingdom are hosting a free, international online symposium dedicated to emergency medical services and palliative care on 18 January 2022 at 15.00 CET.
Marek Uhlíř, a paramedic at the Prague Emergency Medical Service in the Czech Republic and coordinator of project TIERA (Terminal Illness Early Recognition in Ambulance Settings), explains more and welcomes you to join the symposium.
“Ambulance service, emergency line, hello” is a sentence that I say about a hundred times on my average shift. I work as a paramedic at Prague Emergency Medical Service (EMS) metropolitan dispatch centre, which receives an average of 209,000 emergency calls per year, 570 per day, one call every two and a half minutes.
“I am so sorry to call in the middle of the night, but I don’t like the way my mother is responding to me.” The timer on the screen is running while I type to the computer: in this case, I note the address, assess the patient’s level of consciousness (unresponsive) and breathing (rapid, regular, without cyanosis), assign a priority to the call to a 67-year-old female and send the ticket to operational command. The clock shows fifty seconds. My colleague pages the nearest rapid response unit, while I stay online with the caller. The mother has metastatic cancer, has lost 12 kilos of weight over the last two weeks, became sleepy over the last few days and unresponsive in the last hour. I click on the history log, which shows four calls from this patient in recent weeks. “KQZ 116 for dispatch, good morning, on our way,” I overhear from the radio terminal – pager beeping and sirens in the background. The clock shows two minutes, ten seconds. “Has someone in the hospital talked to you about palliative care?” I ask the caller. “What? No, what for?”
Emergency medical services (EMS) frequently respond to calls involving patients in the advanced stages of incurable diseases. The real challenge is: how to respond to the needs of patients at the end of life, who may require acute management, but might only have limited benefit from transfer to hospital?
In Prague, two years ago, we started looking around, hoping to find someone who could have a ready-to-implement solution. We went through national registers to know how many EMS calls are dispatched to end-of-life patients and looked to the literature to see what makes our patients approach the end of their lives under blue lights and sirens. We found research by Dr Wiese in neighbouring Germany and Georgina Murphy-Jones, who explored paramedic decision making. Georgina and colleagues infuse the palliative into paramedicine in London, seeking to improve quality of care through service development and education for over 3500 EMS clinicians. Dr Surakka explores the participation of paramedics in end-of-life care in Northern Karelia, a remote Finnish region. Dr Carter and her colleagues in Halifax, Canada, break down the silos by adding training and resources for paramedics to provide a palliative approach to care, on-site; this is currently being scaled to other provinces. In Prague, we have been screening all incoming emergency calls since July with Rapid-PCST, a three-item version of a Palliative Care Screening Tool adapted for use at the emergency dispatch centre (results to be published) and we are hosting an international online symposium dedicated to EMS and palliative care in January 2022.
Certainly, there are a lot more of us, paramedics and emergency physicians, out there who ask the same questions and try to add an important layer of extra care for our patients. We strongly believe that a network of emergency practitioners, passionate about both pre-hospital and palliative care, can change the trajectories of hundreds of thousands. Let’s meet!
Join the free, online symposium – Working Across the Gap: Palliative Care Programmes in Ambulance Settings
Register here for the online symposium, Working Across the Gap: Palliative Care Programmes in Ambulance Settings, to be held on 18 January 2022 (15.00-18.00 CET, 14.00-17.00 GMT). Registration is free of charge.
- For more about TIERA (Terminal Illness Early Recognition in Ambulance Settings), contact Marek Uhlíř by email.
COMING UP… FREE WEBINAR ON PUBLIC PALLIATIVE CARE EDUCATION
The latest in the European Association for Palliative Care (EAPC) webinar series will be presented by the EAPC Task Force on Last Aid and Public Palliative Care Education on Thursday 13 January at 3 pm CET – see blog post here or register here.