Impeccable Assessment Research Articles

The Declaration of Venice

In May 2006 at the Fourth Research Forum of the European Association for Palliative Care (EAPC) in Venice Italy, recognizing that the World Health Organization definition of palliative care calls for “impeccable assessment and treatment of physical symptoms and of psychological, social and spiritual problems,” the EAPC and the International Association for Hospice and Palliative Care (IAPC) introduced a declaration to develop a global palliative care research initiative.

Palliative care in SA Family Practice

Extracted from text ... SA Fam Pract 2006:48(6) CPD Editorial Palliative care in SA Family Practice Dr E Gwyther Palliative care is an important aspect of clinical management and all health care professionals should develop the knowledge and skills required to manage patients and their families who are facing the diagnosis of life-threatening illness. WHO Definition of Palliative Care Palliative Care is an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering, the early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and ..

Advanced Head & Neck Cancer: Care Beyond Cure

Head and neck cancer patients have some premorbid features which make them a more challenging group compared to those with cancers in other anatomic regions. They have a tendency to abuse or have abused alcohol, tobacco or both; they may be less meticulous in personal habits, especially oral care, tend towards poor nutrition and have a higher incidence of personality and character disorders. They are also less successful socio-economic group. Most of those who succumb to head and neck cancer have uncontrolled local disease irrespective of the presence of metastasis. Distant metastasis arises in lung, liver and bone in a small number of patients particularly if there is involvement of multiple lymph nodes. The recent cancer estimates show that out of 10 million new cancer cases diagnosed annually 0.675 million patients suffer from head and neck cancer and 60% of all head and neck cancer occur in less developed countries 1. The 5-year survival rates of multimodal chemoradiotherapy is below 20%, with a median survival of 12 months or less 2,3,4. According to WHO (2002) 'Palliative Care' is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical ,psychosocial and spiritual .Palliative care is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life such as chemo therapy or radiation therapy and includes those investigations needed to understand better and manage distressing clinical complications. It is usually apparent that palliative treatment may differ from curative treatment but in certain situations the borderline between the two may be blurred and a clear-cut distinction may not always be possible in many T3 and T4 primary lesions in recurrent disease. Accompanying the great expansion of ablative and reparative cure in head and neck cancer over the past three decades, the scope for palliation has also improved substantially and perhaps over a broader field than curative therapy. These are the following symptoms from which Head & Neck cancer (HNC) patient suffers.

Palliative sedation.

Concerns about suffering usually arise as patients contemplate end of life. For most, an array of available therapies will alleviate suffering. However, for others, these therapies may not be adequate, despite impeccable assessment and management. In these circumstances, palliative sedation may be an option for the relief of suffering. As patients, families, and clinicians contemplate this option, controversies and concerns about hastening death, euthanasia, and limiting life-sustaining therapies can arise. This article explores some of these concerns.

Preanesthetic Assessment of the Multiple Trauma Victim

Summary The multiple trauma victim taxes even experienced anesthesiologists, emergency physicians, and trauma surgeons. Appropriate care centers around organized planning, team cooperation, communication, and an appreciation of concerns relevant to all involved specialties. The preanesthetic evaluation should begin upon the arrival of the patient to the admitting area. Evaluation and initial stabilization often occur simultaneously, with particular attention given to the cardiopulmonary and neurologic systems. Anesthetic management needs to be tailored individually recognizing the type of injury, organ system involvement, and response to initial therapy. In short, impeccable assessment is the key to successful management and outcome.