Palliative care in the Critical Care Unit.
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Authors
Frew, Katherine
Snell, David
Issue Date
2019
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Abstract
The critical care unit is a setting in which critically ill patients receive high-intensity treatments such as mechanical ventilation to sustain life. These patients are at high risk of dying such that critical care clinicians manage dying patients and their families on a daily basis. Management on a critical care unit is associated with a high level of symptoms, and palliation of suffering is important throughout the course of treatment. Treatment is frequently intrusive and some patients with advanced disease may not wish to undergo critical care, particularly if their deterioration indicates progression of their disease rather than a reversible complication. If deterioration occurs despite intensive therapies and it becomes apparent that ongoing interventions are likely to merely prolong the dying phase, the focus of care should switch to optimizing comfort and making the death as dignified as possible. Intrusive treatments that are not contributing to symptom control are withdrawn and opioids and benzodiazepines are used to relieve distress. Although often unpredictable, because of the severity of illness, once life-sustaining treatments are withdrawn, the dying phase may be short.
Description
Citation
Frew K.E., Snell D. (2019) Palliative Care in the Critical Care Unit. In: Bourke S., Peel T. (eds) Integrated Palliative Care of Respiratory Disease. Cham: Springer, pp 199-209.
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Integrated Palliative Care in Respiratory Disease
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ISSN
9783030189433