End of life for the experts-a practical framework for intensive care professionals

Abstract

Aims & Objectives: This presentation will build confidence and skills in dealing with end of life situations in the PICU by presenting a simple and practical framework that recognizes the pre-existing expertise of an intensive care audience. Methods End of life conversations and decision making are core skills for intensive care professionals that cannot be outsourced, however it is these situations that often challenge us most deeply as individuals and teams. The author's unique training and specialist experience in both pediatric intensive care and pediatric palliative care will be used to present a simple and practical framework to navigate end of life care in the PICU, while recognizing the high level of experience and expertise within an intensive care audience. Results A simple but powerful 5-step process will be presented that is based on current concepts in the literature and honed in daily practice-the “Benefits vs. Burdens” decision making framework, the process of building professional consensus, discussing the patient's situation compassionately and honestly, offering active palliative care within the “Zone of Parental Discretion” and coming to a lasting and satisfying agreement with the family and patient that allows both clinicians and families to thrive as long term survivors. Conclusions Intensive care professionals are already the experts in end of life care for their patients and can further benefit from a guide to help them see and discuss clearly, navigate apparent differences between themselves, patients / families and other health care professionals and build healthy coping strategies for long term survival and success.L6238153292018-09-13 <br />