Avis palliatifs aux urgences durant la première vague COVID-19 : quels bénéfices ? Une étude auprès des urgentistes

At Paris’ Saint-Louis hospital, the collaboration and organisation of the ER teams and those from the palliative care units was completely transformed, at least for a time, by the brutal arrival of SARS-CoV-2. Faced with the necessity of the moment, and initiated by the mobile palliative care team, the absence of structured exchanges of information was replaced with a daily briefing within the ER hospitalisation unit, with the aim of anticipating a possible request to quantify any patients requiring evaluation and palliative care on-site, as well as accompanying the ER doctors and other medical staff present. Beyond describing the patients taken into care under this system, and the benefits in terms of palliative care, a qualitative study conducted with ER doctors allowed us to evaluate the real and perceived benefits, and to conclude that a greater presence of the mobile accompaniment and palliative care team at ER allows for better use of their resources and a subsequent modification of the care pipeline for certain patients. This work shows the fundamental contribution that a mobile palliative care team can make in receiving and treating ER patients, while also improving the experience of the teams faced daily with individuals at the end of their lives. However, it also brings to light a patent lack of palliative care culture in ER services, as well as the absence of a reflex to make use of this type of expertise systematically, despite the benefits being universally acknowledged, opening the way for the joint development of veritable palliative care for acute cases.