Hospital/emergency department admissions:

• Patient has presented to the emergency department more than once in one month for the same diagnosis
• Patient has had >2 hospital admissions within 3 months for the same diagnosis
• Patient has a hospital stay of >5 days without evidence of clinical improvement
• Patient has prolonged ICU stay, or >2 ICU transfers on same admission, without evidence of clinical improvement
• Patient in ICU setting with multiorgan failure

Ventilators:

• Prolonged or failed attempt to wean from ventilator
  • Consideration of rapid weaning from ventilator with expected patient death
• Consideration of transfer of ventilator-dependent patient to long-term ventilation facility

Other clinical criteria that could prompt a palliative care consultation:

• Metastatic cancer with failure of multiple regimens of treatment
• Neurologic complications of cancer
  • Brain metastases
  • Spinal cord compression
  • Carcinomatous meningitis
• Advanced lung disease with frequent exacerbations
• Advanced cardiac disease requiring consideration of LVAD or IV pressors
• Advanced renal disease with deterioration despite dialysis
• Neurodegenerative disease considering feeding tubes or ventilator support
• Anoxic encephalopathy
• Stroke with resultant function decreased by 50 percent, considered life-limiting
• Catastrophic multiple trauma 
   

For more information about Palliative Care Solutions, please call 877.868.4827.