Abstract
Patients receiving palliative care may deteriorate suddenly due to their illness or another acute medical or surgical problem. Management options depend on life expectancy, level of intervention needed, and an assessment of risks, benefits, side effects and likely outcome. Symptom control and supportive care may be the most appropriate management if the patient is dying. Treatment options are to be discussed with the patient and family; if possible, discussion and documentation of the patient’s wishes should be made in advance including those about resuscitation, hospital admission and transfer to an intensive care unit.