309 Emergency Case Study

Table 3. The Recorded Chief Complaint for 309 Emergency
Department Visits (EDVs).
Chief complaint No. %
Pain 141 45.6
Abdomen 92 29.8
No specific site 15 4.9
Back 10 3.2
Chest 10 3.2
Headache 6 1.9
Mouth 5 1.6
Lower limb 4 1.3
Neck 4 1.3
Pelvis 3 1
Upper limb 1 0.3
Dyspnea 41 13.3
Vomiting 38 12.3
Fatigue/weakness 34 11
Altered consciousness 32 10.3
Fever 21 6.8
Bleeding 16 5.2
Diarrhea 15 4.9
Cough 13 4.2
Anorexia 11 3.6
Constipation 10 3.2
Care for catheter/intravenous line 7 2.3
Nausea 6 1.9
Dehydration 4 1.3
Jaundice 4 1.3
Urinary symptoms 4 1.3
Other 3 1
Skin symptoms 3 1
Edema 2 0.6
Insomnia 2 0.6
Suffocation 2 0.6
Agitation 1 0.3
Cardiac arrest 1 0.3
Convulsions 1 0.3
Dysarthria 1 0.3
Dysphagia 1 0.3
Hoarseness 1 0.3
Hypotension 1 0.3
Some of EDVs in the current study were due to changes that are likely to happen at the EoL, for example, anorexia and weakness. Educating caregivers about these changes may prevent the initiation of unnecessary EDVs by anxious caregivers.
It may be also useful to find predictors for EDVs by PC patients.21 This may be helpful in planning the care of PC patients who are more likely to visit the ED.
The results of the current study should be interpreted in view of its limitations. This was a single center retrospective observational study. In addition, patients who may have died at home were not included. For included patients, data of EDVs in other hospitals were not available.
Conclusions
The majority of patients who died of cancer in our setting and other settings visit the ED at the EoL. The main cause of EDVs
4 American Journal of Hospice & Palliative Medicine®
Downloaded from ajh.sagepub.com by guest on April 16, 2015 among patients with terminal cancer is uncontrolled symptoms, particularly pain. Many of these EDVs are potentially preventable.
Further research is needed to find and examine the