Palliative Pearls

January 2018 - The point of prognostication is not to be right, but to help people prepare. Avoid the trap of exact numbers. Develop a prognosis that is good enough to allow for important decisions to be made around advanced planning, therapeutic interventions, and...

December 2017 - The risk of intracranial or GI hemorrhage in a debilitated ambulatory patient at risk for falling likely exceeds the benefit of stroke reduction.* Most experts agree that anticoagulation should not be used in these cases - Patient has a high risk of...

October 2017 - "VitalTalk Tips" – A free app to help you with difficult conversations. VitalTalk Tips is free and easy to use. Its layered structure allows you to use it to quickly review a topic before a difficult conversation or to study in greater depth. It sends a...

September 2017 - Opiates cause constipation by several mechanisms: - Binding intestinal mu receptors and slowing peristalsis - Delaying gastric emptying - Increasing anal sphincter tone - Increasing water and electrolyte reabsorption from slowed peristalsis. Our...

August 2017 - Establishing Durable Power of Attorney for Healthcare (DPOA-HC) is a gentle way to start advance care planning. In the state of Washington, if no DPOA-HC has been established, the responsibility for medical decision making for an incapacitated adult...

July 2017 - Study shows burden may outweigh the benefit for managing hypertension in elders with a history of falls. Antihypertensive medications were associated with an increased risk of a serious fall injury, particularly among those with previous falls. The...

June 2017 - Olanzapine has “broad spectrum” activity for difficult to treat nausea. Olanzapine has broad activity at dopaminergic and serotonin receptors as well as activity along histaminic, muscarinic, and alpha-adrenergic pathways. Nausea treatment includes...