In an emergency
Knowing what to do in an emergency
What to do when someone is dying
When someone is dying, many people’s first instinct is to call 999 for help. Often, this will be the right response, but think carefully; is this an expected deterioration and event, or is this a sudden and unexpected deterioration?
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If this is an expected deterioration and the person has chosen not to be resuscitated (and this has been identified in their ReSPECT form with the support of their healthcare professional), then you should consider calling their GP, rather than 999. Outside working hours, you can call 111, rather than 999. In any other instance or if the person is suffering (and currently does not have a nursing team supporting end of life care) you should call 999.
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This is important, because when you call 999 for emergency assistance during an unexpected deterioration, it is the ambulance service's duty to proceed in the person's best interest, which usually includes a resuscitation. This will happen automatically unless the ambulance service are immediately shown the correct documentation (such as a ReSPECT form), detailing the patient's specific wishes not to be resuscitated.
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Being resuscitated is not always what people want, particularly if the person has been suffering from a terminal illness and has been preparing to die. It can be very distressing for them and also for their family members or loved ones to see that the ambulance crew have to resuscitate the person, rather than make them comfortable in their last hours.
You can find more information by visiting the NHS website:
www.nhs.uk/conditions/do-not-attempt-cardiopulmonary-resuscitation-dnacpr-decisions/.
If you or a loved one decide that you would not want to be resuscitated, you can speak to your GP about creating a ReSPECT form, so that your wishes are formally recorded and so that paramedics or ambulance crews and doctors will be in a position to support your wishes to the best of their ability.
Other emergency numbers you can call
You can ask your GP which services will be available to you during the day and out of hours. During opening hours you should be able to call your GP surgery. It is important to explain that your call is concerning end of life, so that your call can be prioritised and you can be helped quickly and effectively.
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Your GP can arrange for a Single Point of Access (SPA) and give you their contact details. This number gives you access to direct contact with the district nurse for administration of end of life medications. Whilst the GP may initially be your immediate point of contact, you may also be supported by carers, who can provide end of life pain medication or support. When further medication is required, because someone is in pain, seems agitated or is breathless, it can often be quicker to contact the SPA team, rather than a GP, as they are more likely to be able to come quickly and they can usually provide further mediation as required, without having to refer to your GP first.
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The nationwide Single Point of Access (SPA) number is 0300 300 7777. Try to ensure that you have this number readily available by your phone, so that you can respond quickly and calmly, should you need to.
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Other useful contacts
Leicestershire and Rutland Adults' Services
0116 255 1606
07511 213 133
07511 213 145
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Children's Services Leicester City
0116 454 1004
County and Rutland Children's Services
0116 305 0005
Or if you are being supported by one of our local hospices:
LOROS
Leicestershire and Rutland Organisation for the Relief Of Suffering (LOROS), Groby Road, Leicester,
24 hour advice line - 0116 231 3771
During office hours, doctors and specialist nurses can contact consultants directly via their personal assistants on 0116 231 8437 / 8416.
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Sue Ryder
Thorpe Hall, symptom management admissions and end of life care
0808 164 4572
What can you do to avoid unnecessary admission to hospital?
Many people in Britain will experience several emergency admissions to hospital in their last year. Sometimes this is necessary and can aid their quality of life, but often it can be avoided, especially when the right care is available at their home or in the community. Admissions to hospitals can be very distressing for the patient and their families, which can impact the quality of their life.
So what can you do to avoid unnecessary hospital admissions? The first person to speak to is your GP, who can help to identify what end of life care is needed and what care will be available to you, so that you can put together an advance care plan and have a list of emergency contacts to call.
It is always much easier when people who are approaching end of life have expressed their wishes and that has been documented in care plan and ReSPECT form. The ReSPECT form will be completed by a health care professional (often a GP or hospital doctor) following conversation with the person and their family (if that is the individual's wishes). Your GP will keep a copy of the ReSPECT form and you should also have a copy so that you can share this with any other care provider who supports you.
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In some areas you can get support from Marie Curie nurses who can provide care in the community at any time in the day. They also offer a rapid response service so that patients and their family can access information and advice over the phone and urgent nursing care in their home.
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Marie Curie
0800 090 2309
www.mariecurie.org.uk
What you should do when someone has died
If the death was expected and a ReSPECT form is in place, then you can contact their GP or (outside working hours) call 111. You may have to wait for several hours before the GP is able to visit. This is not unusual.
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You may need to take time to take everything in, as a death, even when you have been expecting it, can affect everyone very differently. If you are on your own, take time to call someone who is close to you and who can support you. ​
It may be necessary for the GP or a medical professional to provide a formal verification of death and this will be arranged for you. If the death was sudden or unexpected, or if the GP has not seen the deceased person for some time before their death, the Coroner may have to be informed, and the police may also be called to the house. This is not unusual and you should not be alarmed by this. Arrangements will be made for transporting the deceased person into the care of the Coroner’s service while further investigation takes place.
After death verification by a healthcare professional, you can contact your chosen funeral home for them to collect your loved one when you are ready. For further information on what legal and practical arrangements to make following someone’s death, visit the after a loss page on this website.
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If a death was not expected and the person was not on an end of life pathway, you should call 999 immediately.