Today, Emergency Physicians are beginning to initiate and manage more and more end of life (EOL) care patients in the emergency department (ED). Despite all the challenges that makes the ED non-condusive for these discussions, whether from the perspective of the concept of emergency care or the lay-out of EDs, there must be strategies and action plans to incorporate EOL care and discussions into the modus operandi of EDs. Emergency Medicine (EM) programmes and departments must be prepared to invest in dedicated time, training, space, resources and partnership networks to ensure EOL care and discussions can be carried out efficiently and effectively.

We are proposing a framework, The SPECIAL Model, for EOL discussions and management in the ED. It is being proposed to handle a delicate, emotional and sensitive matter. With adequate training planned by EM programmes, experience and the use of the SPECIAL Model, EPs can certainly aspire to deliver safe and high quality EOL care in the ED, 24 hours a day. SPECIAL is a pneumonic : S (Structured), P(Patient-centric Plans), E(Environment), C(Constant, Care Updates), I(Interpersonal Communications), A(Advanced Care Plans and other Advanced decisions), L(Life Quality). It is easy to remember and can be used as a memory jerk when EPs have to discuss these challenging issues.

TBA