Palliative Care During COVID-19: Data and Visits From Loved Ones.
Laura Heath, Sharon Yates, Matthew Carey and 1 others
PMID 32705889WHAT IT FOUND
In 31 patients who died of COVID-19, breathlessness and delirium were common.
All had subcutaneous anticipatory medications prescribed, including opioid and midazolam, with median last-24-hour doses of 20 mg oral morphine equivalent and 10 mg midazolam. Few had family present.
Key findings
01Among 31 patients, breathlessness was reported in 84% and agitation/delirium in 77%.
02All patients had subcutaneous anticipatory medications prescribed, and the most frequent administered combination was an opioid with midazolam.
03Only 19% had a loved one present when dying, although all patients had a documented Do Not Attempt Cardiopulmonary Resuscitation decision.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It included only 31 patients from one hospital, so the symptom and medication pattern may not apply elsewhere. The patients were racially and ethnically homogeneous, reflecting the local population. It was a retrospective quality improvement survey, so it describes documented care rather than testing a treatment. Efficacy was documented in only 50% of patients who received as-needed medication, so symptom control is not fully reported. It only describes patients who died under palliative care, not patients who recovered or received care elsewhere.
Declared interests
The authors declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not read the reported medication doses and symptom prevalence as proof that this approach works. The paper is a retrospective survey of 31 patients from one hospital, and it describes documented care rather than testing a treatment.