Updates from the Journal of Palliative Care

Airway Ethics Palliative Care Pediatrics

What is “Safe Enough” for Kids at Home with a Trach?
June 26, 2025June 19, 2025

Spoon Feed —
This ethics case study explores the impact of rigid discharge criteria for patients discharging home with tracheostomy. The study highlights the impact of bias on our assessment of safety and the importance of balancing safety with respect for family autonomy.

Source
Safe Enough: Subjective Determinations in Hospital Discharge for Patients With Medical Complexity. Pediatrics. 2025 Jun 1;155(6):e2024067585. doi: 10.1542/peds.2024-067585. PMID: 40355131

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Emergency Medicine Palliative Care

Emergency Department-Initiated Palliative Care
February 26, 2025February 26, 2025

Spoon Feed —
Comprehensive palliative care training for emergency department clinicians and nurses did not have an effect on admission rates, subsequent visits, or 6-month mortality.

Source
Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial. JAMA. 2025 Jan 15. doi: 10.1001/jama.2024.23696. Epub ahead of print. PMID: 39813042

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Family Medicine Internal Medicine Palliative Care

Code Status Talk – Convey Information or Emotion?
January 15, 2025May 5, 2025

Spoon Feed —
In code status discussions, a patient-values-centered framework was superior to an information-centered framework in making patients feel heard and understood.

Source
Patient Preferences for Code Status Discussions: A Randomized Trial of Information- vs. Patient Values-Centered Frameworks. J Gen Intern Med. 2024 Dec 11. doi: 10.1007/s11606-024-09243-2. Epub ahead of print. PMID: 39663339

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Hematology/Oncology Internal Medicine Palliative Care

Early Palliative Care in Patients with Advanced Cancer
November 13, 2024December 6, 2024

Spoon Feed —
In this small randomized trial in South Korea, early intervention with palliative care (EPC) demonstrated benefits in physical and emotional functioning in patients with advanced cancers not responding to standard chemotherapy. Survival benefit was noted for patients with greater than 10 palliative care interventions.

Source
Early Integrated Palliative Care in Patients With Advanced Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2024 Aug 1;7(8):e2426304. doi: 10.1001/jamanetworkopen.2024.26304. PMID: 39115845

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Critical Care Emergency Medicine Palliative Care

High-Flow Nasal Cannula for DNR-DNI Palliative Patients
June 4, 2020October 15, 2024

Spoon Feed —
High-flow nasal cannula is an effective way to relieve dyspnea in hypoxic palliative care patients who do not wish to be intubated.

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Critical Care Emergency Medicine Palliative Care

How long until death after palliative extubation?
August 8, 2016October 15, 2024

Median time to death after palliative extubation was 8.9 hours but up to a week. This is probably not best to do in the ED.

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