palliative care for cancer patients in the emergency department in iran

between 33%-46% of admissions in the emergency department(ed) are advanced or end-stage cancer patients. they usually stay in emergency for days for management of their symptoms (commonly pain and respiratory distress) or for terminal care. barriers for delivering palliative care services in the ed:- traditional attitude among the ed staff that practice life saving approaches for every patient regardless of their disease. - ambiguous medical rules to protect the ed staff from legal action against them if they refuse to provide futile treatments to satisfy the patients' family with unrealistic expectations. - lack of knowledge about palliative care philosophy regarding the better symptom management and terminal care. - to see mortality rate as a failure of the healthcare system even for advanced, incurable cancer patients. there are some suggestions for improving care of this group of patients in the ed. references rondeau df, schmidt ta. treating cancer patients who are near the end of life in the emergency department. emerg med clin n am. 2009; 27 (2): 341-5. smith ak, fisher j, schonberg ma, pallin dj , block sd , forrow l , et al. am i doing the right thing? provider perspectives on improving palliative care in the emergency department. ann emerg med. 2009; 54(1): 86-93. quest te, bone p. caring for patients with malignancy in the emergency department: patient-provider interactions. emerg med clin n am. 2009; 27(2): 333-9. gisondi ma, quest te, emanuel ll. palliative and end-of-life care in the emergency department. emergency medicine & critical care. 2009; 14(5): 46-8. grudzen cr, stone sc, morrison rs. the palliative care model for emergency department. j palliat med. 2011; 14(8): 945-50. kenen j. palliative care in the emergency department. ann emerg med. 2010; 56(6): 17a-19a. meier de, beresford l. fast response is key to partnering with the emergency department. j palliat med. 2007; 10(3): 641-5. beemath a, zalenski rj. palliative emergency medicine: resuscitating comfort care? ann emerg med. 2009; 54(1): 103-5.