Supportive Care in the Emergency Department

Contributed By:
Dr. Leon Yeh, Medical Director of Emergency Services – OSF Saint Francis Medical Center

Supportive care brings together a variety of needed services that influence the care given to patients we see daily in the emergency department. Both supportive care and palliative care programs and teams in the hospital bring together doctors, nurses, care managers, ethicists, patients and families to discuss and truly understand a patient’s end-of-life wishes. This may include a discussion about Do-Not-Resuscitate (DNR) orders and advance care planning.

An emergency department visit can be a scary and confusing time for both patients and their families, especially when faced with the final stages of life. It is comforting for everyone involved to know how to proceed in a manner that respects a patient’s desires. That is exactly what our supportive care and palliative care team members do. They help to remind our caregivers that the patient’s wishes and requests come first.

There is often temptation to apply every technology and medical treatment for life-threatening or life-ending illnesses and injuries even if medical science knows these things to be incurable.  Supportive care refocuses our attention on the truly important objective, which is to extend the patient’s quality of life by making them more comfortable and giving them more time to spend with their loved ones.

Last Updated: November 5, 2018

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About Author: Robert Sawicki, MD

Doctor Robert Sawicki photoDr. Robert Sawicki is the Vice President of Clinical Services for OSF Home Care and Post-Acute Services. He has led efforts to develop and improve care for patients with chronic illnesses and has a special interest in end-of-life care and hospice.

Dr. Sawicki received his medical degree from Rush University in Chicago, Illinois, and completed his residency in family medicine in Rockford. He practiced family medicine in Bloomington, Illinois, for 20 years before moving into leadership roles with OSF Home Care Services.

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Categories: Palliative Care & Hospice

2 Comments

  • Dr. Yeh, I applaud you for leading by example. The emergency department visit is a small crucible of time in which life-altering decisions are made. Therefore, there is no place in the hospital where supportive care is more important (in my opinion), because usually, all therapies applied or declined in the ED, set the trajectory of care for the remaining hospital visit….or the rest of that patient’s life. What we do or do not do in the ED matters so much. Thank you for speaking up on this subject and for re-focusing us “ER folks” on “quality of life.”

  • Robert Sawicki, MD says:

    Thank you, Dr. Williams-Murphy! It is wonderful to see that patient and family centered goals of care can, in fact, be considered in the Emergency Department. Many times, in the heat of the moment, we act somewhat “automatically”, and often that is the correct response. We need to remember that just because a patient wants help and shows up at the ED, it doesn’t mean that the help they want is the “full court press”. Sometimes they need comfort, symptom management, or even just reassurance. I applaud your efforts to continue to refocus us on our patients!