急診病人之安寧緩和醫療照護

台灣已邁入「高齡社會」，2026年我國老年人口將超過20%成為「超高齡社會」。對於老年人的緊急醫療及相關的緩和醫療(palliative medicine)之需求必須做好因應及準備，美國急診醫師學院(American College of Emergency Physicians, ACEP)提出共十項聰明就醫(Choosing Wisely)，其中的第3項明確告知急診醫師與醫護同仁：對可能受益的患者，不要延遲為他們提供可用的緩和療護和安寧照護服務。儘早從急診部門就啟動安寧緩和醫療照護服務可以使這些患者受益，從而提高其生活品質，甚而延長其生存期間。急診部門將為老年急診醫療複雜患者提供安寧緩和醫療照護服務，藉由跨團隊成員提供緩和療護處置，近期文獻都表明這將改善病人生活品質、減少住院時間和急診再返就醫、提高患者和家屬的滿意度，導致重症加護的利用率降低、並節省大量成本。醫療－個人，從出生、成長到過世，都要好好照護，過程中做疾病治療，無法治癒的病，就需做療護。讓病人善終、家屬善生，協助後續身心靈的「療癒」，達到生死兩相安。

關鍵字

緩和療護；安寧照護；急診；聰明就醫

並列摘要

Taiwan has entered an ＂old age society＂. In 2026, more than 20% of the elderly population in Taiwan will become ＂super-aging society＂. This is the need and preparation for emergency medical care, related palliative care and hospice care for the elderly. American College of Emergency Physicians (ACEP) proposed a total of 10 smart medical questions (Choosing Wisely). Question-3: Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit. Emergency physicians should engage patients who present to the emergency department with chronic or terminal illnesses, and their families, in conversations about palliative care and hospice services. Early referral from the emergency department to hospice and palliative care services can benefit select patients resulting in both improved quality and quantity of life. The emergency department will provide access to palliative care and end-of-life care for medically complex patients in the Geriatric ED. By providing multidisciplinary teams for palliative care interventions, recent literature suggests this will improve quality of life, reduce hospital length of stay and ED recidivism, improve patient and family satisfaction, result in less utilization of intensive care, and provide significant cost savings. Medical care should be taken care of from birth, growth, and death. In the process of disease treatment is to cure, incurable diseases require care. Let the patient be peaceful at the end of his life and the family members are good at life. We will help to follow-up the ＂healing＂ of the body and soul, and make life and death peaceful.

並列關鍵字

palliative care ； hospice care ； emergency department ； choosing wisely

國際替代計量

急診病人之安寧緩和醫療照護

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