BUMC Basics.pdf - Anesthesia Home

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• Institutional Ethics and Palliative Care link on the Baylor
home page
Hospice/comfort care measures
Helpful medications/orders if you are transitioning to in-patient
hospice and comfort care:
• The hospice nurse will write orders as she evaluates the
needs of the patient and call you to make
recommendations and get your verbal approval if the
patient is going on in-patient hospice.
• Excess Secretions: Scopolamine patch behind ear
once every 72 hours; if still struggling, can add atropine
1% ophthalmic solution, 2 gtts under tongue Q3 hours prn
• Fever: Tylenol 650 mg PO or per rectum Q4-6 hours prn
pain/fever
• Nausea/Vomiting: Phenergan 12.5 to 25 mg PO or per
rectum Q6 hours prn nausea or vomiting
• Pain regimens: Consult above; can try morphine gtt,
titrate to comfort if patient is nearing end of life and pain
not able to be controlled with orals or patch.
• Air hunger: Morphine 1-2 mg per hour prn; add Oxygen
by NC at 4-6 L, but write for nurse to not check O2 sats as
this is for comfort only.
• Constipation: Milk of magnesia, Miralax, Senna, or
Dulcolax on a daily basis. Constipation is better prevented
than treated. Do not use fiber supplements to treat
constipation due to opioids or at the end of life.
• Wheezing: A/A nebs q4 hours prn.
• If patient aspirates and is under aspiration precautions,
including ordered to be NPO status, consider changing
this to comfort feedings.
• Other symptomatic treatment as needed. Pastoral
services are always available.