Table 1.

Examples for clinical situations with possible triggers and benefits

Clinical situation	Possible trigger	Possible benefit from specialized palliative care (sPC)
Relatives are informed about a possible limitation of the patient's lifetime. They perceive that the ICU team is putting a lot of effort into symptom control. Nevertheless, they would like an integration of sPC (e.g. due to own burden)	Relatives’ sPC request	The sPC team can support the ICU team in caring for relatives. Together they can provide the best possible care for those affected. Thus relatives experience support and relief
The patient suffers from complex symptoms	High symptom burden	The sPC team can use its expertise and perspective to assess symptom burden and to recommend strategies to alleviate it. Together with the ICU team and their expertise, the best possible symptom control can be achieved
The patient has an inoperable, advanced tumor. He receives maximum intensive care therapy over a longer period of time, which is continued and not adapted to any new therapy goals that may need to be achieved	Unresectable malignancy	In the case of a serious life-limiting underlying disease, sPC can be consulted regardless of the indication for intensive care. The ICU and sPC team can work together to assess the situation and realistic therapy goals. Consequently, they plan and implement treatment and care for the patient's comfort