What can we learn from the death of the #Queen? The world has watched her live through the process of #OrdinaryDying, and yet dying went unspoken, un-named. Let's notice what nobody mentioned: we all saw the Queen going through the stages of ordinary dying. A 🧵... 1/

As the dying person becomes more deeply unconscious, they don't respond to secretions building up at the back of the throat - "the person is safely unconscious" - this is the "death rattle", and indicates deep levels of unconsciousness. #MakingDyingBetter

Breathing changes at the very end of life - breaths become cyclical, going fast and slow with pauses. It may sound like they are panting - they aren't, it's just the respiratory centre in the brain shutting down. #MakingDyingBetter

Next problematic theme is patients who wish to stop eating & drinking to hasten their death - Voluntary Stopping of Eating & Drinking (VSED). It is not "assisting a death" to support and palliate people whose capacitious wish is to do this. Sarah Malik at #makingDyingBetter

🗣️🗣️🗣️ 'CPR is not a treatment for ordinary dying.' 🗣️🗣️🗣️ #MakeDyingBetter

🗣️🗣️🗣️ 'Dont ask a patient "What do you want us to do if your heart stops?" unless they would be a candidate for CPR.' 🗣️🗣️🗣️ #MakeDyingBetter

Dr Linda Dykes has moved to Bluesky Times to #HaveTheConversation 1. Make it a routine part of initial assessment: "Any PoA, ADRT etc I should make a note of? No? Well, .... let me tell you about how those could help you...' 2. "Any allergies? Any treatments you wouldn't want?" 3. ➡️

💡 ⌚ 🔇👂💙 #FrontlineCommunication #toptips #MedTwitter

Unpopular opinion: You can learn more about a child’s clinical condition by spending a few moments looking at them than you can by attaching any monitor.

Never forget that anxiety by itself is a diagnosis of exclusion

A man in his 70s with acute chest pain and paced rhythm. See what happened. Pendell Meyers hqmeded-ecg.blogspot.com/2023/05/a-man-…

Introducing the OMI Pocket Guide. Smith ECG Blog Posts organized into an amazingly educational collection, with examples of each type of subtle OMI and of mimics. Also on the banner at the top for easy access any time hqmeded-ecg.blogspot.com/p/omi-pocket-g…

The financial costs of anticipatory prescribing: Median prescription cost £43.17 & used drug cost £2.16 Our new paper in Palliative Medicine Lloyd Morgan Cambridge Palliative & End of Life Research Group Pls share widely ⬇️ ⬇️ WeCommNurses 💙 RCN District and Community Nursing Forum Hospice UK Dr Sarah Russell RN CareHomesQI 💚 💙 The Queen's Nursing Institute doi.org/10.1177/026921…

Planning a gathering over the festive season? Why not include a #WhatMattersToMe conversation? 🧵 It's a joyful topic, & it can be the very thing that helps you understand each other better, or represent each other's views if that's ever needed in the future. Some resources: 1/

JWP Isle of Wight Ambulance Service Other key theme was the PGD was predominantly used in those overlooked by "traditional models" of palliative care eg those with dementia, chronic illnesses with unpredictable acute exacerbations etc. The paramedics gave immediate symptom relief then flagged to us to pick up

Today was the first time utilising the recently implemented end of life PGD suite. It allowed myself and my colleagues to initiate rapid symptom relief and meet the patient's priorities of care safely and effectively whilst establishing an onward chain of care. Empowering.

Abbé Émile Warré was born on this day in 1867 (Some sources suggest May 9th) A French abbot, he devised a simple, economical, 'bee-friendly' hive known as the 'People (Warré) Hive.' The hive consists small 300mm x 210mm square boxes. It doesn't use frames, just eight top bars

Mike Stone Idris Baker Prof. Mark Taubert Royal College of General Practitioners Dr Rachel Clarke The BMA Clare Gerada k *Wouldn't it make sense to have a local EoL care backup team? 24/7 phone line with flying squad able to despatch a prescriber to assess & help manage breakthrough symptoms like pain, agitation, breathlessness? Even to attend immediately after death if companions need support? 4/

Want to improve your ReSPECT discussions & create more useful ReSPECT forms? Try this structure, devised by Geris trainees Martha Twigg & Carmaline de Silva. Full-res PDF (to print off) at lindadykes.org/downloads and it's #FOAMed - please do share by whatever means you like!