Released: 3/14/2022
Expires: 3/13/2025

3/14/22

Palliative Care for Trauma Patients is a TCAA course created from a previous live webinar in which Dr. Cook reveals the benefits of primary palliative care as an integrated part of trauma care, the different models to incorporate into your trauma program, and provides communication tools needed to provide palliative care. 

Estimated completion time: 60 minutes
Target Audience: The Trauma healthcare team and other clinical departments
Learning Objectives

At the conclusion of this course, the learner should be better able to:

1. Describe the difference between primary and secondary palliative care and the benefits of primary palliative care as an integrated part of trauma care.  
2. Describe three models of palliative care integration into trauma care and list pros/cons for each approach in their own institution
3. Describe the best case / worst case communication tool and be able to analyze and apply the supportive literature for this communication tool.  

Faculty Presenter: Mackenzie Cook 
Moderator: Laura Gamino
Faculty Bio:

Dr. Cook was born in Pittsburgh and grew up in a small town in Connecticut. He attended college at Cornell University in Ithaca, NY and then spent a year backpacking and skiing in Utah before attending medical school at Duke University in Durham, NC. He spent his dedicated research year in medical school at the University of Wisconsin in the endocrine surgery lab as a Howard Hughes medical scholar. He then headed west for residency at OHSU, graduating in 2016 from the general surgery residency program. Following residency, Dr. Cook completed a surgical critical care fellowship at Harborview Medical Center in Seattle, WA in 2017. Dr. Cook lives in Portland with his wife, Crystal, their three kids and two rambunctious dogs. Avid hikers, skiers and climbers, the Cook family is happy to call Portland home.

ACS Trauma Quality Improvement Program (TQIP). (2017). Palliative care best practice guidelines: https://www.facs.org/quality-programs/trauma/tqp/center-programs/tqip/best-practice

Ballou JH, Dewey EN, Zonies DH. Elderly patients presenting to a Level I trauma center with Physician Orders for a Life-Sustaining Treatment form: A propensity-matched analysis. J Trauma Acute Care Surg. 2019 Jul;87(1):153-160. doi: 10.1097/TA.0000000000002321. PMID: 31033897.

Bhangu JK, Young BT, Posillico S, Ladhani HA, Zolin SJ, Claridge JA, Ho VP. Goals of Care Discussions for the Imminently Dying Trauma Patient. J Surg Res. 2020 Feb;246:269-273. doi: 10.1016/j.jss.2019.07.046. Epub 2019 Oct 12. PMID: 31614324; PMCID: PMC7006367.

Bonanno AM, Kiraly LN, Siegel TR, Brasel KJ, Cook MR. Surgical palliative care training in general surgery residency: An educational needs assessment. Am J Surg. 2019 May;217(5):928-931. doi: 10.1016/j.amjsurg.2019.01.008. Epub 2019 Jan 17. PMID: 30678805.

Bradley CT, Brasel KJ. Developing guidelines that identify patients who would benefit from palliative care services in the surgical intensive care unit. Crit Care Med. 2009 Mar;37(3):946-50. doi: 10.1097/CCM.0b013e3181968f68. PMID: 19237901.

Kim, Dennis Y. MD; Lissauer, Matt MD; Martin, Niels MD; Brasel, Karen MD; and the Critical Care Committee of the AAST Defining the surgical critical care research agenda: Results of a gaps analysis from the Critical Care Committee of the American Association for the Surgery of Trauma, Journal of Trauma and Acute Care Surgery: February 2020 - Volume 88 - Issue 2 - p 320-329 doi: 10.1097/TA.0000000000002532

Lynn, J. (2005). Living long in fragile health: The new demographics shape end of life care. Hastings Cent Rep Spec No: S14-18.

Mosenthal AC, Murphy PA. Interdisciplinary model for palliative care in the trauma and surgical intensive care unit: Robert Wood Johnson Foundation Demonstration Project for Improving Palliative Care in the Intensive Care Unit. Crit Care Med. 2006 Nov;34(11 Suppl):S399-403. doi: 10.1097/01.CCM.0000237044.79166.E1. PMID: 17057605.

Mosenthal, A. C., Murphy, P. A. (2003) Trauma care and palliative care: Time to integrate the two? Journal of the American College of Surgeon. 197. 509-16.

Mosenthal AC, Murphy PA, Barker LK, Lavery R, Retano A, Livingston DH. Changing the culture around end-of-life care in the trauma intensive care unit. J Trauma. 2008 Jun;64(6):1587-93. doi: 10.1097/TA.0b013e318174f112. PMID: 18545128.

O'Connell K, Maier R. Palliative care in the trauma ICU. Curr Opin Crit Care. 2016 Dec;22(6):584-590. doi: 10.1097/MCC.0000000000000357. PMID: 27661439.

Schockett ER, Prather CP, Benjenk I, Estroff JM. Integrating Palliative Care on an Adult Trauma Service. J Palliat Med. 2021 May;24(5):668-672. doi: 10.1089/jpm.2020.0378. Epub 2020 Sep 22. PMID: 32960125.

Suwanabol PA, Reichstein AC, Suzer-Gurtekin ZT, Forman J, Silveira MJ, Mody L, Morris AM. Surgeons' Perceived Barriers to Palliative and End-of-Life Care: A Mixed Methods Study of a Surgical Society. J Palliat Med. 2018 Jun;21(6):780-788. doi: 10.1089/jpm.2017.0470. Epub 2018 Mar 13. PMID: 29649396; PMCID: PMC6909736.

Task Force on Surgical Palliative care; Committee on Ethics. Statement of principles of palliative care. Bull Am Coll Surg. 2005 Aug;90(8):34-5. PMID: 18435115.

Taylor LJ, Nabozny MJ, Steffens NM, Tucholka JL, Brasel KJ, Johnson SK, Zelenski A, Rathouz PJ, Zhao Q, Kwekkeboom KL, Campbell TC, Schwarze ML. A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case. JAMA Surg. 2017 Jun 1;152(6):531-538. doi: 10.1001/jamasurg.2016.5674. PMID: 28146230; PMCID: PMC5479749.

Udelsman BV, Lee KC, Lilley EJ, Chang DC, Lindvall C, Cooper Z. Variation in Serious Illness Communication among Surgical Patients Receiving Palliative Care. J Palliat Med. 2020 Mar;23(3):411-414. doi: 10.1089/jpm.2019.0268. Epub 2019 Oct 2. PMID: 31580763; PMCID: PMC7643760.

https://www.vitaltalk.org/

Dr. Nancy W Weber
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