PALLIATIVE CARE – DR ADRIAN DABSCHEK
Limited presence at Footscray, but phone consultations available
DEMENTIA
- admission to Aged Care predicts decline
Difficult Discussions Towards End-of-Life
- practice the conversation
- understand the patient’s and family background..”the patient’s journey”
ANTI-EMETICS IN PALLIATIVE CARE SETTING (beware of side effects f used in normal ED setting)
Cyclizine – incombination with dexamethaosine for raised ICP
Haloperidol – high doses often used, combined anti-psychotic effects, effective in renal failure
Ondansetron – effective in chemotherapy and radiotherapy induced N + V
Olanzepine – chemotherapy induced N + V, also antianxiety, 2.5-5mg nocte
CANCER PAIN
Physiology – inflammation vs neuropathic pain
Long acting opiates – breakthrough doses are 1/6 of long acting dose
Rotate opiods to reduce tolerance: Morphine -> oxycodone -> hydromorphone
Fentanyl patches – good for stable cancer pain, fentanyl syringe driver in renal failure
SMART CLINIC – Footscray weekly, open to non-cancer patients, Sunshine twice weekly (oncology patients)
COPD BUNDLE OF CARE – Dr Lexi Gerber
LFA-COPD-X-doc_V3.02_0815_WEB
DKA – Dr Tamarind Reynolds
hyperkalaemia
hypothermia
difficult IV access
intubation and ventilation challenges
management of shock