Comunicação sobre limitação terapêutica em pacientes em terminalidade no atendimento de urgência e emergência: revisão sistemática com síntese narrativa temática

Introduction: The urgency and emergency care setting challenges the management of end-of-life patients, demanding effective communication to avoid futile interventions and ensure dignity at the end of life. Objective: To research communication regarding the limitation of life-sustaining treatment in terminally ill adult patients in emergency settings, identifying strategies, barriers, and facilitators. Methods: A systematic review (PRISMA 2020) was conducted in the PubMed database (2016–2026), utilizing thematic narrative synthesis. Results: Nine primary studies were included. Communication in emergency care proved to be predominantly reactive and delayed. Barriers include overcrowding, high care demands, lack of a prior patient-provider relationship, and ethical-legal insecurity. Conversely, facilitators such as brief advance care planning interventions, early discussions with families, and nursing team involvement reduced disproportionate procedures. Conclusion: Improving care requires transitioning to a proactive and protocol-driven approach, supported by continuing education, clear guidelines, and integration among emergency care, palliative care, and primary healthcare.