Paeds Vivas · pain-palliative-and-end-of-life-care
Care in the last days of life — branching viva
Branching viva on care in the last days of life: definition and ethical standard, classification, stepwise plan, contested escalation, and family or sibling support.
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RACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A four-year-old with progressive metastatic solid tumour is now bed-bound, taking only sips, with irregular breathing and increasing periods of unresponsiveness. The family wish to remain at home if symptoms can be controlled.
Opening question
A four-year-old with progressive metastatic solid tumour is now bed-bound, taking only sips, with irregular breathing and increasing periods of unresponsiveness. The family wish to remain at home if symptoms can be controlled. Give the one-sentence definition and the governing ethical standard. [1]
References4ShowHide
- [1]Himelstein BP et al. Pediatric palliative care. N Engl J Med, 2004.PMID 15103002
- [2]McNeilly P et al. The use of syringe drivers: a paediatric perspective. Int J Palliat Nurs, 2004.PMID 15365495
- [3]Wee B et al. Interventions for noisy breathing in patients near to death. Cochrane Database Syst Rev, 2008.PMID 18254072
- [4]Greenfield K et al. A mixed-methods systematic review and meta-analysis of barriers and facilitators to paediatric symptom management at end of life. Palliat Med, 2020.PMID 32228216