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News
End-of-life patients with severe breathlessness in the ER are often not getting the relief they need. A new study found that only 15.2% of dying patients with dyspnea received morphine in the emergency department, compared to 68% who received it after admission. Researchers say earlier palliative care integration and better ED protocols could close this critical gap.
A retrospective study out of Israel found a striking disparity in how morphine — a key comfort medication for breathlessness — is used in the emergency department (ED) versus inpatient settings for patients at the end of life. Of 250 patients who came to the ED with severe dyspnea and died during the same hospitalization, only 15.2% received morphine in the ED, while 68% received it once admitted. Among those who did get morphine in the ED, the average wait time was nearly 6 hours.
Patients with lung cancer or a do-not-resuscitate (DNR) order were significantly more likely to receive morphine in the ED — suggesting that clearer end-of-life status prompts better symptom management. Importantly, morphine use in the ED was not associated with shorter survival, countering a common concern among clinicians.
Why it matters: The ED is often where dying patients first seek relief, yet it's also where palliative symptom management is most underutilized. The authors call for clinician education, standardized symptom-management protocols, and earlier palliative care integration in EDs to ensure patients receive timely comfort care at their most vulnerable moment.
