LAUSR

Coronavirus disease 2019 (COVID-19) is a global pandemic, with New York holding the unenviable title of “epicenter” for COVID-19 in the United States. Given the extremely poor prognosis of critically ill COVID-19 patients who require mechanical ventilation, particularly the older patients or those with chronic comorbidities, it has become imperative to clarify goals of care (GOC) in a timely fashion. The surge of critically ill COVID-19 patients in the emergency department (ED) prompted an increased demand for early identification of GOC and treatment preferences. Early GOC clarification may help avoid using scarce resources for patients who do not want them. At our institution, we implemented an ED-based COVID-19 palliative care response team, focused on providing high-quality GOC conversations in time-critical situations. In this article, we discuss the specific challenges of time-critical, ED GOC conversations as they relate to the COVID-19 pandemic, as well as our experiences and approach.