Palliative Care in the ED – Induction

A 78-year-old gentleman has been brought into the department via ambulance. He is in the last hours of life. The nursing team ask if you can write-up some medication to help with his respiratory secretions. Which of the following could be used for this?

You prescribe 60mg of oral codeine to patient with traumatic uncomplicated back pain. You wonder how much oral morphine (Oramorph) this is equivalent to?

A 30-year-old woman is brought into the emergency department with a history of metastatic breast cancer. The disease has spread to her brain, lungs, pelvis, ribs and spine. It is clear when she arrives that she is in the last few hours of her life with a GCS of 3/15. After discussion with her family, it is decided to palliate her, in what are her final hours. The nurse asks you to write-up some medications to help her if she develops agitation.

Which of the following medications can be used for managing terminal agitation?

A 75-year-old man is brought into the emergency department with a history of metastatic prostate cancer. The disease has spread to his bones, lungs and liver. It is clear when he arrives that he is in the last few hours of life, having a GCS of 3/15. Despite this low GCS, he is persistently vomiting. After discussion with his family, it is decided to palliate him in what are his final hours. The nurse asks you to write-up some medication to help him with his vomiting.

Which of the following medications can be used for managing vomiting in this end of life setting?