Palliative Care Package

Essential Package of Palliative Care for COVID-19Copy Link!

Updated Date: December 20, 2020

The following table is adapted from: WHO Clinical management of COVID-19.

Interventions

Medicationsa

Equipment

Human resourcesb

Social support

Prevention and relief of pain or other physical suffering,c acute or chronic, related to COVID-19

- Amitriptyline, oral

- Bisacodyl (senna), oral

- Dexamethasone, oral and injectable

- Diazepam, oral and injectable

- Diphenhydramine (chlorpheniramine, cyclizine, or dimenhydrinate), oral and injectable

- Fluconazole, oral

- Fluoxetine, oral

- Furosemide, oral and injectable

- Haloperidol, oral and injectable

- Hyoscine butylbromide, oral and injectable

- Ibuprofen (naproxen, diclofenac, or meloxicam), oral

- Lactulose (sorbitol or polyethylene glycol), oral

- Loperamide, oral

- Metoclopramide, oral and injectable

- Metronidazole, oral, to be crushed for topical use

- Morphine, oral immediate release and injectable

- Naloxone, injectable

- Omeprazole, oral

- Ondansetron, oral and injectabled

- Oxygen

- Paracetamol, oral

- Petroleum jelly

-Pressure-reducing mattresses

- Nasogastric drainage and feeding tubes

- Urinary catheters

- Opioid lock boxes

- Flashlights with rechargeable batteries (if no access to electricity)

- Adult diapers or cotton and plastic

- Doctors (with basic palliative care training)

- Nurses (with basic palliative care training)

- Community health workers (if available)

Prevention and relief of psychological sufferinge, acute or chronic, related to COVID-19

- Amitriptyline, oral

- Dexamethasone, oral and injectable

- Diazepam, oral and injectable

- Diphenhydramine (chlorpheniramine, cyclizine or dimenhydrinate), oral and injectable

- Fluoxetine, oral

- Haloperidol, oral and injectable

- Lactulose (sorbitol or polyethylene glycol), oral

- Adult diapers or cotton and plastic

- Doctors (with basic palliative care training)

- Nurses (with basic palliative care training)

- Social workers or psychologists

- Community health workers (if available)

Prevention and relief of social suffering, acute or chronic, related to COVID-19

- Social workers

- Community health workers (if available)

- Income and in-kind supportf

Prevetion and relief of spiritual suffering, related to COVID-19

- Local spiritual counsellors (after vetting)

aBased on WHO Model List of Essential Medicines (2015). Acceptable alternative medicines are in parentheses: ( )

b Doctors may be local or foreign and may be surgeons, anesthesiologists, intensivists, infectious disease specialists, pediatricians, general practitioners, palliative care specialists, or others. Nurses may include nurse-anesthetists.

cOther physical suffering includes breathlessness, weakness, nausea, vomiting, diarrhea, constipation, pruritus, bleeding, wounds and fever.

dOnly necessary at hospitals that provide cancer chemotherapy or radiotherapy.

ePsychological suffering includes anxiety, depressed mood, confusion or delirium, dementia and complicated grief.

fFor patients living in extreme poverty and for one caregiver per patient. Includes cash transfers to cover housing, children’s school tuition, transportation to health care facilities or funeral costs; food packages; and other in-kind support (blankets, sleeping mats, shoes, soap, toothbrushes, toothpaste).