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4 results

  • 55 - Care of the Dying Patient

  • from Section 12 - End of Life
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 591-597

  • Summary

    • Palliative medicine focuses on maximizing the quality of life of patients with serious illnesses. For many patients in the critical care setting, the best medical treatments and technologies are unable to reverse advanced disease processes, as evidenced by the fact that 20% of Americans died in or after ICU care. Even when treatments can prolong life, they may not ultimately allow patients to achieve a quality of life acceptable to them. Functional and cognitive independence are highly valued by patients and yet most chronically, critically ill patients never live independently again. Honest, transparent, empathetic communication is the cornerstone of determining how to deliver effective, patient-centered medical care for these patients.

  • 67 - Care of the dying patient

  • from Section 12 - End of life
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 451-456

  • Summary

    This chapter discusses the care management of the dying patient. It describes special circumstances with regard to family members such as young children of dying patients, and with regard to organ donation. Dying in the critical care setting most often follows the withholding or withdrawal of life-sustaining treatments and therefore has its own unique trajectory. When critical care is no longer achieving patient-centered goals and/or the patient is dying despite aggressive use of life-sustaining therapy, a meeting should be held to determine the goals of care. Withdrawal of ventilator support or liberation from the ventilator is a common step preceding death in the intensive care unit. If desired, families should be informed regarding the estimated survival time once ventilator support is discontinued, as this allows for adequate preparation and planning. Prognostic estimates should be communicated as time frames: minutes to hours, hours to days, or days to weeks.