Improving Care for the End of Life, Online Edition The Palliative Care Policy Center

Sourcebook : Improving Care for the End of Life : 4.2 Treat Dyspnea by Improving Management of Ventilator Withdrawal

Dyspnea is one of the many symptoms that occur when patients are weaned from ventilators; others include pain, anxiety, and excessive secretions. The decision to remove life support is difficult for families and health care providers. The goal during this process is to maintain patient comfort. Terminal weaning differs from traditional weaning because the process continues, regardless of the patient's vital signs, and comfort measures are used despite their effect on vital signs.

UCLA Medical Center

UCLA Medical Center has a policy for terminal weaning that requires informed consent by the patient or surrogate, collaboration among all members of the health care team, and discussions with families to describe the process and alternative methods. The policy also recommends that other professional staff, including social workers and chaplains, be notified of the family's wishes and be available should the family request help. Patients and families are assured privacy, time to grieve, and quick access to all caregivers.

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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.

For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].

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