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NSW AMBULANCE AUTHORISED PALLIATIVE CARE PLAN

23/8/2016

 
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People of all ages with palliative care needs often access care through their local family General Practitioner (GP) and Community Palliative Care Nurse. Families and carers also have an important role in supporting individuals with palliative care needs in the home, particularly in the after-hours period when community health service providers may be more difficult to contact..
Patients in palliative care and their carers now have an option of working with their GP to close the after-hours gap.
 
Patients and their family may request their GP to complete a NSW Ambulance Authorised Palliative Care Plan. Once endorsed by NSW Ambulance, this plan specifically authorises NSW Ambulance paramedics to deliver individually tailored treatment based on the GP’s advice as documented in the plan.
 
In the event of a Triple Zero (000) call-out by the patient, the NSW Ambulance Authorised Palliative Care Plan may be initiated. This may include administration of medications and other actions to relieve and manage symptoms in the home.
 
This plan allows the paramedic responding to a Triple Zero (000) call to respect the palliative care wishes of the patient and follow the GP’s advice.
 
It is understood that families and carers are often well prepared with education and support, including medication regimes to help manage breakthrough pain and other symptoms in the after hours period. It is also understood that on occasion, things don’t work and more help is needed.
 
In the after hours period when sudden changes in health may lead to uncertainty, NSW Ambulance Triple Zero (000) service is commonly a first response. In the absence of detailed clinical knowledge about the patient, the paramedic’s response is protocol based and transfer to the hospital emergency department is generally required.
 
This transfer is often not the optimal outcome in these situations and may be avoidable. For a patient with palliative care needs, transfer may be avoidable if the paramedic has access to an authorised palliative care plan.
 
NSW Ambulance Authorised Care Plans are not confined to palliative care patients. They encompass:

Authorised Paediatric Palliative Care Plans for children under the care of the Children’s Hospital Network or their treating clinician. This plan gives the family and/or enduring guardian the opportunity to discuss treatment and transport options for the patient, namely to remain at home with support services in place for the length of care, or to be transported directly to a predetermined health facility.

Authorised Adult Palliative Care Plan for adult patients under the care of their treating clinician where treatment and/or transport options have been discussed and noted in the Authorised Care Plan.

Authorised Care Plan for patients with special medical conditions under the care of their treating clinician. This plan enables paramedics to administer pre-authorised medications and procedures outside of NSW Ambulance’s normal practice.

Qualified paramedics are authorised to administer the medication, and/or procedures listed on the Palliative or Authorised Care Plan. It is the responsibility of the treating clinician to ensure all fields are completed prior to submission.
 
This is well worth considering and not just for palliative care patients.
 
Anne McR., Australia
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