Research Article

Challenges Faced by Prehospital Emergency Physicians Providing Emergency Care to Patients with Advanced Incurable Diseases

Table 2

Improvement suggestions for prehospital emergency care in patients with advanced incurable disease.

Categories and subcategoriesDefinitions and examples

Category 1Structural modifications
1.1. Emergency system structureStructures for better care on-site and further support
“It [the emergency system] is not prepared for it. […] and the resources because our vehicles aren’t equipped for it” (1, 103)
1.2. DocumentationThorough documentation to help clarify the situation and justify therapy in patients with advanced incurable diseases
“Information needs to be better prepped and communicated. Like a map or something. There’s always an info sheet. But that’s never on palliative care. Always general info like the medication chart. But never a palliative care concept. That would be beautiful, but it hardly ever happens” (2, 90)
1.3. Specialized prehospital palliative care services accessibilityA wider range of specialized palliative care emergency services for focused treatment
“The only preferable option, if palliative care facilities were to be more centered for those patients. For strategies with a primary acute palliative care team that’s called instead of an emergency physician” (18, 106)

Category 2Education and training
2.1. Adaptations in EP qualificationPalliative care as an addition to the standard emergency care curriculum
“It’s not mentioned on the emergency physician course. How to treat palliative care patients is not ranked very high in the emergency medicine educational world, but trauma, resuscitation, cardiac insufficiency and coronary heart disease” (21, 59)
2.2. Further practical training/experience in palliative carePractical experience in a specialized palliative care unit and further training in applied palliative care
“If you could organize for us emergency physicians to join the palliative care unit. For more information and a certain practice. Those two things would help, would help me” (13, 66)
2.3. Further qualifications informing on palliative care and facilitiesWorkshops and widespread information about palliative care and available structures, their indication, and utilization
“To get to know more about prehospital palliative care, whether there are options for a quick organisation of such care” (5, 80)

Abbreviations: EP, emergency physician.