The Kirkwood Palliative Care Toolkit

Management of common palliative care symptoms during the COVID-19 pandemic.

We have created The Kirkwood Toolkit for use by our colleagues managing patients with life limiting illness. Included are guidelines relating to general issues related to care in life limiting illness, but we have also produced bespoke guidance specifically for COVID-19, including advice if supplies of standard medication are limited, and specific guidance on management of intractable symptoms related to COVID-19 exposure. Particular guidance on future care planning / advance planning at this time is also provided.

You will find links to download these as PDF documents at the bottom of this page.

Some of the treatments suggested are licensed medications being used for unlicensed indications. This information is provided in good faith based on the available evidence, but the responsibility ultimately lies with the prescriber.

Thank you for your continued support with patient care. We continue to maintain all our services, though some have to operate in different ways, so please continue to refer to the Community team and use the Advice Line (Tel: 01484 557 910).

We can connect with patients and carers through AccuRx and can provide remote team working through Microsoft Teams. Please let us know if we can help in other ways.

We hope this will be an evolving toolkit dependent on identified needs and if you have any specific requests or feedback please email me directly at stephen.oxberry@thekirkwood.org.uk. Please note that this toolkit has been devised in response to urgent community need and content is a guide only. Professionals remain responsible for their own clinical advice and decision making.

November 2020 update

"Thanks to all of you for your ongoing support of patients with life limiting illnesses in these challenging times. We have updated the toolkit with new information and links regularly this year but have performed a formal update in November 2020 and the website reflects this. Please continue to refer patients to The Kirkwood, utilise the toolkit and contact us if you have any specific or particular needs that we might be able to help with." - Dr S G Oxberry

 

Advance Planning and Escalation

• Advance care planning during COVID-19 (MD158)
• Advance care planning during COVID-19: Conversation tips (MD180)
• Frailty Scoring and escalation of treatment (MD169)

Managing symptoms

• Early management of secretions (MD163)
• Early management of intractable breathlessness (MD164)
• Early management of delirium and agitation (MD170)
• End of life management of secretions (MD165)
• End of life management of breathlessness and cough (MD166)
• End of life management of delirium and agitation (MD171)
• Management of dry eyes and dry mouth at end of life (MD181)
• COVID-19 Fever management in palliative care (MD168)
• COVID-19: Care of the dying patient when ABLE to obtain a syringe driver (MD174)
• COVID-19: Care of the dying patient when UNABLE to obtain a syringe driver – injectable alternatives (MD172)
• COVID-19: Care of the dying patient when UNABLE to obtain a syringe driver – non-injectable alternatives (MD175)

Medication and prescribing

• Alternatives to common palliative care drugs: Strong opioids (oral and transdermal) (MD159)
• Alternatives to common palliative care drugs: Strong opioids via syringe driver (MD160)
• Opioid conversion chart (MD161)
• Guidance on anticipatory medication (MD162)
• Prescribing oxygen for community patients during the COVID-19 pandemic (MD177)

Sources of information

• Sources of national information and Kirkwood contacts (MD167)