• Irene M Spinello and Kern Medical Center, Department of Medicine, Bakersfield, CA, USA.
• Kern Medical Center, Department of Medicine, Bakersfield, CA, USA. spinelloi@kernmedctr.com
• J Intensive Care Med. 2011 Sep 1; 26 (5): 295-303.

AbstractProper critical care training and management rests on 3 pillars-evidence-based patient care, proficient procedural skills, and compassionate end-of-life (EOL) management. The purpose of this manuscript is to provide a practical guide to EOL management for all bedside practitioners. The manuscript outlines not all but some fundamentally important ethical concepts and provides helpful rules and steps on end-of-life management based on my own personal experience and practice. Moreover, nowhere in the rigorous training of critical care or hospitalist physicians do we teach the procedure for removal of life-sustaining measures. Like any other procedure in medicine, it requires preparation, implementation and conclusion, as well as supervision and repetition to become proficient. Therefore, at the conclusion of this paper, an attempt is made to correct this lack of training by providing such outline and a guide. © SAGE Publications 2011.

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