Palliative Care in Cardiac Intensive Care Units

Palliative Care in Cardiac Intensive Care Units
Author: Massimo Romanò
Publisher: Springer Nature
Total Pages: 195
Release: 2021-09-29
Genre: Medical
ISBN: 3030801128

This book analyzes the main topics of Palliative Care in Cardiac Intensive Care Units (CICU), from the changing epidemiology of patients admitted to the ICU, to the main clinical and ethical issues. The changing epidemiology of patients has led to new and emerging patient needs at the end of life. Care has shifted from acute coronary syndrome patients towards elderly patients, with a high prevalence of non-ischemic cardiovascular diseases and a high burden of non-cardiovascular comorbid conditions: both increase the susceptibility of patients to developing life-threatening critical conditions. These conditions are associated with a significant symptom burden, high mortality rate, and increased length of stay. The main new challenges involve shared decision-making, symptom control (pain, dyspnea, etc.), and ethical issues (withholding/withdrawing life sustaining treatments, deactivation of implanted cardiac devices, palliative sedation), all of which necessitate formal education on end-of-life care. Written by opinion leaders in their respective fields, who share their experience with improving the cultural and clinical competence of medical/nursing teams, this volume is chiefly intended for cardiologists, anesthesiologists, palliative care doctors and nursing staff.

End of Life Care in the ICU

End of Life Care in the ICU
Author: Graeme Rocker
Publisher: OUP Oxford
Total Pages: 416
Release: 2010-01-28
Genre: Medical
ISBN: 019923924X

This book highlights real clinical issues which need to be addressed if quality palliative care within ICUs is to be consistently delivered. It is presented in an easily accessible, bullet pointed style, and is illustrated with case histories from real-life patients, and drug tables.

Managing Death in the ICU

Managing Death in the ICU
Author: J. Randall Curtis
Publisher: Oxford University Press
Total Pages: 407
Release: 2001
Genre: Medical
ISBN: 0195128818

A clear and concise statement of facts and causes that have led step by step to the present deplorable condition of public affairs and the corruption of the body politic"--Preface.

Mount Sinai Expert Guides

Mount Sinai Expert Guides
Author: Stephan A. Mayer
Publisher: John Wiley & Sons
Total Pages: 658
Release: 2020-12-01
Genre: Medical
ISBN: 1119293308

Part of the Mount Sinai Expert Guide series, this outstanding book provides rapid-access, clinical information on all aspects of Critical Care with a focus on clinical diagnosis and effective patient management. With strong focus on the very best in multidisciplinary patient care, it is the ideal point of care consultation tool for the busy physician.

Extreme Measures

Extreme Measures
Author: Dr. Jessica Nutik Zitter, M.D.
Publisher: Penguin
Total Pages: 353
Release: 2021-08-24
Genre: Medical
ISBN: 0525533419

For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.

Dying in America

Dying in America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 470
Release: 2015-03-19
Genre: Medical
ISBN: 0309303133

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Improving End-of-life Care in the Intensive Care Unit

Improving End-of-life Care in the Intensive Care Unit
Author: Mercy Joseph
Publisher:
Total Pages: 0
Release: 2015
Genre: Evidence-based nursing
ISBN:

The end of life care has rising focus nowadays associated with increasing life expectancy and advanced technologies to prolong life. Advance care planning and initiation of palliative care services bring hope to the patient population to enhance the quality of life at their end stages of life. According to the study shows, there are 22% of death happens in the intensive care unit in the United States (Troug et al, 2008), so the pursuit of quality care has increased interest in the designated area. Based on the research studies, the advance care planning and the comfort care services enhance quality of life, decreased use of life sustaining treatments, decreased hospital length of stay, increased use of hospice or palliative care services, and better patient/family cope up and satisfaction. The main objective of the study is to enhance the quality of life among patients with terminal and chronic life limiting illness by implementing a strategic plan of end of life care. The implementation plan includes the use of Physician orders for life sustaining treatment form (POLST) for all ICU patients, family conferences, routine palliative care consultation, and an added educational training of the health care workers, can provide a holistic care to the dying patients. The comfort theory will be incorporated into the project by assessing the patient needs, nursing interventions, and the evaluation of patient comfort. An end of life care survey has developed to evaluate the family and staff satisfaction with the above implementation plan. A dissemination of the project outcome will be communicated to the stakeholders through open meetings/discussions, staff development program, and make use of the organizational website and newsletters.

Contemporary Bioethics

Contemporary Bioethics
Author: Mohammed Ali Al-Bar
Publisher: Springer
Total Pages: 273
Release: 2015-05-27
Genre: Medical
ISBN: 3319184288

This book discusses the common principles of morality and ethics derived from divinely endowed intuitive reason through the creation of al-fitr' a (nature) and human intellect (al-‘aql). Biomedical topics are presented and ethical issues related to topics such as genetic testing, assisted reproduction and organ transplantation are discussed. Whereas these natural sources are God’s special gifts to human beings, God’s revelation as given to the prophets is the supernatural source of divine guidance through which human communities have been guided at all times through history. The second part of the book concentrates on the objectives of Islamic religious practice – the maqa' sid – which include: Preservation of Faith, Preservation of Life, Preservation of Mind (intellect and reason), Preservation of Progeny (al-nasl) and Preservation of Property. Lastly, the third part of the book discusses selected topical issues, including abortion, assisted reproduction devices, genetics, organ transplantation, brain death and end-of-life aspects. For each topic, the current medical evidence is followed by a detailed discussion of the ethical issues involved.

Palliative Care in Critical Care, An Issue of Critical Care Nursing Clinics of North America

Palliative Care in Critical Care, An Issue of Critical Care Nursing Clinics of North America
Author: Tonja Hartjes
Publisher: Elsevier Health Sciences
Total Pages: 137
Release: 2016-07-22
Genre: Medical
ISBN: 0323395600

Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC). Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses. Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family’s physical, psychosocial and spiritual concerns, and aligning treatments with each patient’s goals, values, and preferences. PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.