# data[].attributes.body
treatment is symptom-based; goal is maximum comfort for patient

# data[].attributes.body
provide comfort and less pain

# data[].attributes.body
A multi-disciplinary approach with an ultimate goal of providing the best comforting care for the patient

# data[].attributes.body
It focuses more on the patient’s comfort and extending his/her quality of life

# data[].attributes.body
Alleviating patient suffering during his/her dying moment

Extending comfort also with the family members helping them understand and accept patient’s situation

-Sean

# data[].attributes.body
- care focused on improving quality of life of the patient rather than aggressively treating the disease itself. - Ranie

# data[].attributes.body
Holistic care to relieve suffering of patients with life-threatening conditions and their families

# data[].attributes.body
Relieve pain and bring comfort to patient who are in end of life state

Provide support to family

# data[].attributes.body
Providing comfort care for the patient

# data[].attributes.body
1/2. YES. Manage Infection/underlying pathology is one way to relieve dyspnea. 3. Depends on patient ACD 4. Depends on patient ACD 5. Morphine for Death Rattle/Pain, HNBB for decreased secretion, Salbutamol, Paracetamol for fever

# data[].attributes.body
1. Yes. the patient is septic - identified a reversible cause

2. Yes. we will give IV antibiotics to treat the possiblity that the patient is septic

3. No.

4. we will not intubate in respect for the patient’s desire for best supportive care.

5. Microboluses of Fentanyl; Salbutamol nebulization

# data[].attributes.body
Reversible acute illness --> pneumonia

Depends on patient goals ("best supportive care" for cancer only? how about other conditions/ illnesses?)

Apprise patient regarding their condition, then reassess goals

1. Yes, if medically indicated

2. Yes

3. Depends

Goals of care

Intubated

4. Yes, if

medically indicated/ life-threatening

with consent if not immediately life-threatening

5. Dyspnea - opioids, anxiolytics; Fever - analgesics; Pain - HNBB, opioids; + Bowel regimen if giving opioids

# data[].attributes.body
1. Yes, as part of supportive care

2. Yes, definitive treatment for the pneumonia

3. No, for Palliative/Hospice care

4. Ideally if w/ indication depending to ROX index but still to consider patient's preference and ask input from SHPM for terminal care

5. Supportive care, alleviate dyspnea/pain, discuss status of paient to family

# data[].attributes.body
1. Yes. For the tx of beginning sepsis

2. Yes. For the tx of CAP

3. If with vacancy, yes. ICU admission optimizes care even for terminally ill px

4. If the patient/family consented for intubation, then yes. If not, we will offer other NIV support such as HFNC. This could still provide support for the patient.

5. Salb+Ipra neb, morphine for pain, paracetamol for fever, NAC for cough, suctioning PRN,

6. Refer to Chaplain if with religious catholic beliefs.

# data[].attributes.body
B (ini)

# data[].attributes.body
B

# data[].attributes.body
B.

# data[].attributes.body
B. Leave him on the fentanyl patch and start fentanyl/morphine infusion on top of this

# data[].attributes.body
C. Remove fentanyl patch and retitrate

# data[].attributes.body
A/C

# data[].attributes.body
1. Pain crisis, secondary to bone metastasis from primary lung CA

2. Opioid-tolerant

3. Morphine 10mg PO x2 --> Morphone 20mg PO --> Morphine 7mg IV every 10 minutes to target NRS 5/10

4. Reassess pain via NRS every 10 minutes

WOF: decrease in sensorium, RR <12

# data[].attributes.body
Metastatic NSC lung cancer, in acute crisis

Opioid tolerant

Morphine 20mg IV every 4 hours

Subjective complaint of the patient

# data[].attributes.body
1. Acute Pain Crisis on top of Chronic pain from Cancer

2. tolerant

3. shift to Morphine IV, 2mg, prn q5min.

4. subjective scoring (VAS/NRS) is still the best indicator

# data[].attributes.body
1. Acute pain crisis from mass effects from Metastatic Lung CA

2. Opioid tolerant

3. Morphine 6mg IV q4 PRN, with VS monitoring

4. Setting goals of pain management to at least 50%; subjective from px

# data[].attributes.body
1. Acute pain crisis from metastatic lung CA

2. Opioid tolerant

3. Give morphine 2mg IV PRN for pain

4. Check for NRS, signs of grimace, VS Q1

# data[].attributes.body
1. A> T/c pleural effusion from malignancy

NSC Lung CA St IV with bone metastasis in acute pain crisis

2. She is opioid tolerant.

3. Morphine 2mg IV q3mins

4. Subjective complaints

# data[].attributes.body
Morphine 20mg TIV (Total daily dose)

# data[].attributes.body
Morphine 20mg IV

# data[].attributes.body
Morphine 20mg IV/SC

# data[].attributes.body
Morphine 20mg IV/SC

# data[].attributes.headline
RHYS/JAC WITH S2 LICENSE AND YELLOW PRES

# data[].attributes.subject
RHYS/JAC WITH S2 LICENSE AND YELLOW PRES

# data[].attributes.body
Please give Morphine 2mg IV q3

Refer prn

Thank you

Drs. Tanghal / Cruz, Galang

# data[].attributes.body
Morphine 20mg IV