End-of-life Models and Emergency Department Care


  • Garrett K. Chan RN, MS

    Corresponding author
    1. University of California, San Francisco, Department of Physiological Nursing, San Francisco, CA; and the San Jose Medical Center, San Jose, CA
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*University of California, San Francisco, 2 Koret Way, Box 0610, San Francisco, CA 94143-0610. Fax: 415-476-8899; e-mail:garrett.chan@nursing.ucsf.edu


Many people die in emergency departments (EDs) across the United States from sudden illnesses or injuries, an exacerbation of a chronic disease, or a terminal illness. Frequently, patients and families come to the ED seeking lifesaving or life-prolonging treatment. In addition, the ED is a place of transition—patients usually are transferred to an inpatient unit, transferred to another hospital, or discharged home. Rarely are patients supposed to remain in the ED. Currently, there is an increasing amount of literature related to end-of-life care. However, these end-of-life care models are based on chronic disease trajectories and have difficulty accommodating sudden-death trajectories common in the ED. There is very little information about end-of-life care in the ED. This article explores ED culture and characteristics, and examines the applicability of current end-of-life care models.