急診醫護人員提供末期照護之相關議題

Issues on End of Life Care from the Perspective of Emergency Medicine

10.6537/TJHPC.2011.16(1).6

謝伶瑜；翁秀霞；呂幸蓉

急診醫療 ； 末期照護 ； 緩和醫療 ； emergency care ； end of life care ； palliative medicine

安寧療護雜誌

16卷1期（2011 / 03 / 01）

74 - 81

繁體中文

急診是照護急性疾病、創傷或提供持續性醫療得以讓病人病況穩定的單位。因此，即使是照護瀕死病人，仍總是被要求盡力提供維生治療，可見緩和醫療在急診並不被重視。因急診醫護人員普遍認為在急診單位提供末期照護有實際面的困難，且醫護人員自身常缺乏末期照護相關資訊，如疼痛控制訓練不足、不知如何與病人或家屬溝通、及對預立醫囑及法規知識不了解等。因此，為能提供給末期病人量身訂做的照護服務，安寧療護是每一位急診醫護人員必修的學分，除具備相關知識、重視病人需求外，更應透過醫病之間良好的溝通及增加預立醫囑利用率，最終讓末期病人獲得平靜死亡的經驗。

Emergency care is focused on the treatment of acute illnesses, injuries or the stabilization of patients for ongoing treatment. Even the dying patient arrives in the emergency room, emergency staffs are requested to provide life-saving care. It is perceived that palliative care is not incorporated into the emergency medical treatment due to most emergency staffs think that providing palliative care in the emergency room have many practical difficulties and they are also lack of end of life care training on pain management, communication skills and legal issues related to advance directives. However, in order to have individualized treatment plan to meet the patient’s goal, all emergency staffs must have basic knowledge in palliative medicine, valuing patient needs, enhancing physician-patient communication and increasing the utility of advance directives for ensuring that individuals at the end of life experience a peaceful death.