Table 5.

Triaging cancer patients for in hospital palliative care and allocation of palliative care resources

High priority	Medium priority	Low priority
Spinal cord compression	Moderate pain (NRS 4-6)	Mild pain (NRS<4)
Impending fracture	Partial response on analgesics	Mild dyspnea
Severe pain (NRS >7/10) of any cause , not manageable at home	Severe increasing dyspnea with known extensive lung metastases	Occasional vomiting
Severe increasing dyspnea (except with known extensive lung metastases)	Postprandial vomiting	Constipation
	Hb 7-8 g/dl not symptomatic	Minor bleeding
Malignant bowel obstruction	Increasing anxiety and/or depression	Hb <7 g/dl but terminally ill
Uncontrolled vomiting	Asymptomatic cerebral metastases	Jaundice in patient with known extensive liver metastases
Severe headache, seizures, confusion		Mild arm or bilateral leg swelling
Severe active bleeding Anemia <7 g/dl with symptoms Acute cholangitis Active DVT New onset agitated delirium Severe depression with suicidal ideation		Progressive confusion in patient with known extensive brain metastases, liver metastases or advanced renal failure Mild/moderate anxiety and or depression Symptomatic cerebral metastases in patients with poor PS or close to end of life
Needs specialized palliative care Hospital admission for management	Needs specialized palliative care First try to manage at home Assistance for management can be provided with teleconsultation. Community based palliative care team should plan for home visits if feasible If home care fails, hospital admission can be considered	Should be managed at home Provide assistance for management via teleconsultation Advanced care planning for terminally ill patients

DVT: Deep vein thrombosis, NRS: Numeric rating scale, PS: Performance status, Hb: Hemoglobin