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Palliative care pearls 
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“Carry a pocket torch and look at you patient’s mouth regularly: mouth care is a vital but often overlooked aspect of comfort and dignity.”
Please add your own and share:
“Carry a pocket torch and look at you patient’s mouth regularly: mouth care is a vital but often overlooked aspect of comfort and dignity.”
Dip a straw fully into a glass of cold water with your finger over the hole on top. This wil allow you to give a patient small drops of fluid by releasing your finger slowly.
If you think a patient needs a syringe driver with Keppra then don’t delay as it can take up to 36 hours to reach steady state.
Opioid induced constipation is easier to prevent than treat for patients. Dont forget simple dietary measures, good hydration and that the colon never develops tolerance to opioids so commit to the duration if treatment with you patient.
Postural hypotension is a common condition in Head and neck cancers. Dehydration, opioids, amitriptyline, neurotoxicity of chemotherapy and disruption of the baroreceptor reflex can all contribute. Check a lying and standing BP on all your patients, obly takes a few minutes 
Some patients will need their transdermal fentanyl patch changed every 48 hours as opposed to 72hours. Look out for yawning, sweating and increased pain prior to day 3.
