The ED is increasingly being called upon to help hospitals and health systems deal with our nation’s growing population of patients with advanced chronic illness. Emergency physicians will continue to advocate and develop new best practices for our most frail and vulnerable patients. By understanding disease trajectory pathways and discussing them with our patients, we can positively influence a patient or family to make appropriate medical decisions.^1–3

References

1. Lamba S, Nagurka R, Murano T, et al. Early identification of dying trajectories in emergency department patients: potential impact on hospital care. J Palliat Med. 2012;15:392-395.
2. Lunney JR, Lynn J, Foley DJ, et al. Patterns of functional decline at the end of life. JAMA. 2003;289:2387-2392.
3. Murray S, Kendall M, Boyd K, et al. Illness trajectories and palliative care. 2005;330:1007-1011.
4. West L, Cole S, Goodkind D, et al. 65+ in the United States: 2010, current population reports. US Census Bureau Web site. Available at: census.gov/content/dam/Census/library/publications/2014/demo/p23-212.pdf. Accessed Oct. 16 2015.

The authors are members of the ACEP Palliative Medicine Section. Dr. Aberger is core faculty in emergency medicine and palliative medicine at St. Joseph’s Regional Medical Center in Paterson, New Jersey. Dr. Fetzer is an emergency medicine attending physician at Advocate Health Care and director of palliative care at Rainbow Hospice and Palliative Care in Mount Prospect and Park Ridge, Illinois. Dr. Goett is assistant professor and assistant director for advanced illness and bioethics in the departments of emergency medicine and palliative care at Rutgers New Jersey Medical School in Newark. Dr. Lamba is associate professor of of emergency medicine and associate dean of medical education at Rutgers New Jersey Medical School. Dr. Rosenberg is chairman of emergency medicine at St. Joseph’s Healthcare System and associate professor of clinical emergency medicine at New York Medical College.