Emergencies are relatively rare in paediatric palliative medicine.  They can be defined as ‘situations needing pre-planning’

The key principles to managing palliative care emergencies are:

• Anticipate that they may happen.
• Recognise early that they are happening.
• Have a plan ready for when they do happen.

Planning for paediatric palliative medicine emergencies should always involve the tertiary paediatric palliative medicine team as early as possible.

There are six emergencies:

• Spinal cord compression
• Catastrophic haemorrhage
• Severe uncontrolled painSuperior vena cava obstruction
• Intestinal obstruction
• Hypercalcaemia

Summary

• Whilst it is true that emergencies are rare in paediatric palliative medicine, they can cause considerable fear and suffering.
• To pre-empt this, those working with children with life-limiting conditions should anticipate the possibility of an emergency, recognise it early and have a plan ready.
• Management of palliative medicine emergencies always requires the involvement of paediatric palliative medicine tertiary services.