Palliative Care Consult 🌿
Guide for palliative care consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: name, MRN, location
- Reason for referral (e.g. symptom management, end-of-life care, prognosis discussion)
- Diagnosis and current clinical status
- Known malignancy or chronic illness
- Code status (e.g. DNACPR)
- Current symptom burden (e.g. pain, dyspnoea, agitation, nausea)
- Medications including analgesia and recent changes
- Psychosocial context, family involvement and wishes
- Any prior palliative involvement or advance care plans
🔍 Investigations to Know
- Recent bloods if relevant (e.g. for renal/hepatic dosing or electrolyte imbalance)
- Imaging if related to symptoms (e.g. CT showing metastases, CXR with effusion)
- Medication chart (especially opioids, benzodiazepines, antiemetics)
- Symptom trends and response to treatments
📞 Example Script
- Hi, this is [Your Name], the intern from [Team Name]. I'm calling to request a palliative care consult for a [Age]-year-old patient with [diagnosis], currently [brief clinical status].
- They are experiencing [e.g. pain, dyspnoea, agitation], and we’d appreciate input on symptom management and goals of care.
- They are [aware/unaware] of the prognosis. Family is [involved/not involved] and [aware/unaware] of the situation.
- We're hoping for guidance on comfort measures and potentially a family meeting.
📝 Tips
- Clarify whether the patient and/or family are aware of the prognosis
- Have symptom history and medication trials ready
- Be honest and compassionate – palliative teams are supportive allies
- Include psychosocial context – living situation, family involvement, and wishes