Contents:
Clinical Guideline for the Management of a Major Haemorrhage (Catastrophic bleed) for Palliative Care Patients.
Introduction
The following clinical guidelines are written for the situation when a major haemorrhage may be expected in the context of advanced progressive disease.
They are only applicable when active management of acute bleeding is not considered clinically appropriate and a major bleed is likely to be a terminal event. Although many patients may be at risk of a major bleed, it is fortunately a rare event.
The goals of management of the event must be to minimise anxiety, ease suffering and ensure death with dignity by providing a calm, reassuring, and caring atmosphere.
Scope
To provide a clear framework to ensure the safe and effective care of a patient who suffers a significant bleeding event due to advanced palliative illness.
It covers assessment of risk and management of bleeding in a number of different settings which may include, surface bleeding from malignant or non-healing wounds, internal bleeding due to malignancy or non-malignant conditions and generalised bleeding due to severe clotting abnormalities.
Definitions
ACP- Advance Care Plan
TEP- Treatment Escalation Plan
ReSPECT- Recommended Summary Plan for Emergency Care and Treatment
Disclaimer
These Guidelines are intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.
Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.
Whilst SPAGG takes every care to compile accurate information , we cannot guarantee its correctness and completeness, and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.