Pediatric Hospital Medicine 2012

A Child's Last Hours: Advanced End-of-Life Care Skills Training For Children's Hospital Staff
Ken Pituch, James Azim, Patricia Keefer, Terry Murphy, D'Anna Saul
At the conclusion of this session, participants will be able to:

  1. Apply a short check-list of issues for real time decision support in end-of-life situations in the hospital.
  2. Anticipate and identify physical and emotional symptoms in the patient, the family and the caregivers
  3. Respond to symptoms with practical interventions including effective language, pharmacotherapy, and non-pharmacologic symptom control.
  4. Identify opportunities for introducing end-of-life training in participants' hospitals.

Children's hospital professionals receive formal training, certification, and retraining in advanced life support. However, in most children's hospitals physicians and nurses are less likely to participate in a code blue than they are to care for a child who will die with orders to not attempt CPR. Training in the important skills required to deliver end-of-life care is rarely a part of the medical or nursing curriculum. In our workshop, participants in small groups will first discuss a case in detail, and then participate in an interactive video scenario simulating the care being delivered to a child dying in the hospital following a decision to limit life-prolonging care. An organized approach to these situations will be provided, along with tools to guide care in this important, under-emphasized area of professional activity. An End-of-Life Algorithms pocket card will be provided, along with the opportunity to practice and receive feedback on methods of assessing and dealing with distressing symptoms in the patient, the family and the other care providers.




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