About Naomi George, MD MPH

Assistant Professor
Center for Adult Critical Care
Department of Emergency Medicine
University of New Mexico Health Science Center

The rapid code status conversation guide for seriously ill older adults in acute respiratory failure

rapid code status

You are working a shift in your emergency department (ED) when an 85 year old female presents with a complaint of altered mental status. She comes from an extended care facility, where paramedics are able to tell you “they called us to come get her,”you are handed a stack of paperwork, given some vital signs, and you notice the patient is altered and unable to provide any further history. You dig a little in the paperwork and note a history of dementia as well as a long list of other medical problems, you notice no known advanced directive, and see that her daughter lives out of state but is available via phone. Have you been here? Seen this patient? If you have worked in emergency medicine long enough you certainly have. The tool outlined below is designed to help you know what to do in these difficult situations.


By |2020-05-31T19:05:01-07:00May 25, 2020|Palliative Care|

PV Card: Palliative Care Screening in the Emergency Department

Palliative Care canstockphoto3674078What is Palliative Care? It is specialized medical care focusing on improving the care and quality of life for patients with advanced illness by decreasing suffering. It can be delivered concurrently with curative care. Early identification of patients who are likely to benefit is key. How do you decide whether your patient could benefit from a palliative care consult?


Hot off the presses

We just published in Academic Emergency Medicine a validated screening tool to identify ED patients who would benefit from palliative care [PubMed abstract].1 In an effort to accelerate knowledge dissemination, the checklist is reproduced here in PV card form. Be sure to check out the thoughtful expert peer review below by Dr. Kate Aberger, who is the chair of the ACEP Palliative Care Section.

PV Card: Palliative Care Screening Tool

Adapted from 1–3

(c) Can Stock Photo

  1. George N, Barrett N, McPeake L, Goett R, Anderson K, Baird J. Content Validation of a Novel Screening Tool to Identify Emergency Department Patients With Significant Palliative Care Needs. Acad Emerg Med. 2015;22(7):823-837. [PubMed]
  2. Grudzen C, Richardson L, Morrison M, Cho E, Morrison R. Palliative care needs of seriously ill, older adults presenting to the emergency department. Acad Emerg Med. 2010;17(11):1253-1257. [PubMed]
  3. Wu F, Newman J, Lasher A, Brody A. Effects of initiating palliative care consultation in the emergency department on inpatient length of stay. J Palliat Med. 2013;16(11):1362-1367. [PubMed]
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