Palliative Care - Navy Medicine

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Case 7 89 M with ESRD, respiratory failure, and sepsis. Wife selects comfort care and desires extubation. His breathing is loud, sounds like a ‘rattle,’ eventually changes to a slow and irregular rate His wife asks is this normal?
Case 7 Response 25% imminently dying patients have noisy breathing (death rattle) “Agonal breathing” is term for slow, irregular pattern near death Avoid term which may connote agony Educate family in advance Consider adjunctive medications Wildiers H, J Pain Symptom Mgmt, 2002
Page 1 and 2: End of Life Care in the ICU C.M. St
Page 3 and 4: Outline (Sobering) epidemiology Def
Page 5 and 6: Comfort care: Definition - Care wit
Page 7 and 8: Case 1 89 M with ESRD, respiratory
Page 17 and 18: What meds may be helpful? Narcotics
Page 19 and 20: How much do I give? Retrospective r
Page 21 and 22: Doctrine of Double Effect “It is
Page 25: Debatable Case 6 Response Probably
Page 29 and 30: Process Create committee with stake
Page 31 and 32: 4 basic sections NMCSD Protocol - G

Palliative Care - Navy Medicine

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