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

Sourcebook : Improving Care for the End of Life : 4.3 Implement Appropriate Ventilator Withdrawal Techniques

The withdrawal of mechanical ventilation is a terminal care process that the patient is not expected to survive. Ventilator withdrawal should be a humane procedure focused on the comfort of the patient and the family.

A small number of case reports and descriptive studies describe the usual practices used during ventilator withdrawal. These studies have investigated the use of analgesics or sedatives, the method for reducing ventilation, and decisions about extubation. Providers must choose a method of sedating the patient before weaning him or her. Faber-Langendoen (1994) surveyed 273 critical care physicians involved in ventilator management during terminal weaning. Of these, 74 percent ordered morphine and 54 percent ordered benzodiazepines.

4.3.1 Analgesia or Sedation
4.3.2 Paralytic Agents
4.3.3 Withdrawal Methods
4.3.4 Case Study - Queen Elizabeth II Health Sciences Centre
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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 [ ] and Oxford University Press. All rights reserved.

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

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