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Dyspnea is the subjective experience of breathing discomfort and affects the quality of life in patients with serious, life-limiting illness.1 2 Dyspnoea is also one of the most distressing symptoms that necessitates visits to the emergency department (ED) in the last six months of life, and it is increasingly ranked the highest in the last two weeks of life.1 In addition to disease-oriented treatments, an adjunct opioid-based treatment for palliation of dyspnoea improves quality of life and functions significantly in patients with advanced respiratory illnesses.1 2 Despite the strong clinical evidence and many national organisations recommending the use of systemic opioids (grade 1B) as an adjunct therapy for relieving dyspnoea in patients with advanced terminal illnesses and refractory dyspnoea at the end of life,2 the utilisation by emergency clinicians is unknown. This study aims to determine the acceptability of this protocol by emergency clinicians and to gain information to improve the protocol implementation.
Due to the pressing need to relieve dyspnea with COVID-19, the palliative symptom management experts in our institution reviewed the current evidence and designed the protocol for acute dyspnoea in the ED, which provided the recommended prescription for all patients who experience any severity of dyspnoea (online supplemental file 1). This study took place in the ED of an academic medical centre. The participants included attending physicians, resident physicians and physician assistants, who provided initial care for patients with moderate to severe dyspnoea in the ED. This included …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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