Effective Palliative Care in the Trauma Setting

A 55-year-old man undergoes emergent exploratory laparotomy and splenectomy following a motorcycle collision. Following surgery, he is found to have a traumatic brain injury requiring decompressive craniectomy and intracranial pressure monitoring. The patient then continues to have complications thr...

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Bibliographic Details
Published in:The American surgeon 2020-11, Vol.86 (11), p.1441-1444
Main Authors: Schultz, Kristen L., Brasel, Karen J., Zonies, David H., Cook, Mackenzie R.
Format: Article
Language:English
Subjects:
Advance directives
Clinical Decision-Making
Clinical Deterioration
Communication
Complications
Decision making
Decision Making, Shared
Family
Fatal Outcome
Head injuries
Hospitals
Humans
Injuries
Intracranial pressure
Male
Middle Aged
Motorcycles
Multiple Trauma - surgery
Multiple Trauma - therapy
Neurosurgery
Ostomy
Palliation
Palliative care
Palliative Care - methods
Patient Care Planning
Patients
Quality control
Quality of life
Skull
Splenectomy
Surgery
Teams
Tracheotomy
Trauma
Traumatic brain injury
Traumatology - methods
Ventilators
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Description
Summary:A 55-year-old man undergoes emergent exploratory laparotomy and splenectomy following a motorcycle collision. Following surgery, he is found to have a traumatic brain injury requiring decompressive craniectomy and intracranial pressure monitoring. The patient then continues to have complications throughout his hospital course. Using the American College of Surgeons Trauma Quality Improvement Program guidelines, the surgical team has early and ongoing primary palliative care discussions to foster communication and determine goals of care for the patient. As the patient deteriorates, the surgical team continues meeting with the patient’s surrogate decision makers to discuss the best case and worst case scenarios regarding the patient’s prognosis and expected quality of life.
ISSN:0003-1348
1555-9823
DOI:10.1177/0003134820960047