All patients should have a goals of care discussion (between the health care team and the patient and/or substitute decision maker) during the first 48 hours of their hospital stay. This is especially relevant for patients with extensive burn injuries, the elderly, and those at high risk of death. Interventions should only be undertaken when they are in keeping with the patient’s previously expressed goals of care or best interests, as determined by the patient’s substitute decision-maker in conjunction with the clinical team.
For more information:
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Bayuo J, Bristowe K, Harding R, et al. The Role of Palliative Care in Burns: A Scoping Review. J Pain Symptom Manage. 2020;59(5):1089-1108. PMID: 31733355.
Mahar PD, Wasiak J, Cleland H, et al. Clinical differences between major burns patients deemed survivable and non-survivable on admission. Injury. 2015;46(5):870-873. PMID: 25707879.
Mularski RA, Puntillo K, Varkey B, et al. Pain management within the palliative and end-of-life care experience in the ICU [published correction appears in Chest. 2009 Aug;136(2):653]. Chest. 2009;135(5):1360-1369. PMID: 19420206.
Pham TN, Otto A, Young SR, et al. Early withdrawal of life support in severe burn injury. J Burn Care Res. 2012;33(1):130-135. PMID: 22240509.
Ray DE, Karlekar MB, Crouse DL, et al. Care of the Critically Ill Burn Patient. An Overview from the Perspective of Optimizing Palliative Care [published correction appears in Ann Am Thorac Soc. 2017 Dec;14(12):1866]. Ann Am Thorac Soc. 2017;14(7):1094-1102. PMID: 28590164.