Guestimates, Estimates, and Survival Curves: Harnessing Science to Inform ED Prognosis for Patients

Original Title: Guestimates, Estimates, and Survival Curves: Harnessing Science to Inform Emergency Department Prognosis for Seriously Ill Patients (Palliative Medicine Interest Group- and Critical Care Interest Group-Sponsored)

Each year, 1 in 10 Americans dies in the emergency department (ED), and more than half of older adults visit in their final months of life. These critical situations demand rapid, life-saving interventions and quick, often difficult decisions on goals of care. This session will explore the essential skill of prognostication for ED providers, addressing four classic death trajectories: sudden death, terminal illness, organ failure, and frailty. We’ll discuss the use of prognostic tools, managing emotionally charged conversations, and effectively communicating with families about end-of-life decisions. Attendees will gain tools and strategies to enhance bedside teaching and provide compassionate, patient-centered care in these high-stakes scenarios.

Learning Objectives:
Upon completion of this session, participants should be able to:
Describe the four core ED Trajectories of Death (sudden, terminal illness, organ failure, frailty), and address varying patient and family needs.
Articulate the dying process stages from pre-active to active, utilizing this knowledge to communicate with families and decision-makers.
Use prognostic tools, emergency medicine resuscitation research, and illness models to estimate seriously ill patient outcomes in the ED.
Employ and teach communication strategies which effectively deliver prognostic information, improve goals of care conversations and enhance shared decision-making with critically ill patients.

Presenters:
Satheesh Gunaga, DO
Naomi George, MD
Justin Kenneth Brooten, MD
Moira Davenport, MD
Fabrice I. Mowbray, PhD, RN