Sarah Vince

"The presumption in Emergency Medicine is that our aim is to prolong life, however, we
should also recognise that alleviating suffering and prioritising quality of life is just as
important. This may be because of sudden unpredictable events such as intracranial
bleeds, or because of a deteriorating chronic disease such as COPD or heart failure. ... Providing end of life care in the ED should go beyond simply managing symptoms and
should consider many other equally important facets of care, some of which will be
unique to the ED. These can be represented by the end-of-life care jigsaw. The jigsaw
has the patient and their loved ones at the centre of the picture, surrounded by eight
pieces of equal size and value, all of which should be considered for those identified
as dying. This allows us to look holistically at the situation and involve the patient and
their loved ones in decisions about their care wherever possible and appropriate, thus
ensuring an individualised person-centred plan is achieved."… (más)