Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
ReviewA scoping review of end-of-life communication in international palliative care guidelines for acute care settings.
End-of-life communication in acute care settings can be challenging and many patients and families have reported low satisfaction with those conversations. ⋯ Palliative and end-of-life guidelines applicable to acute care settings outline the purpose of end-of-life communication and address how, when, and by whom such conversations are best initiated and facilitated. How guidelines are developed and what aspects of communications are included and emphasized may differ across countries related to role differences of physicians and nurses and national laws and regulations.
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J Pain Symptom Manage · Aug 2021
ReviewA scoping review of end-of-life communication in international palliative care guidelines for acute care settings.
End-of-life communication in acute care settings can be challenging and many patients and families have reported low satisfaction with those conversations. ⋯ Palliative and end-of-life guidelines applicable to acute care settings outline the purpose of end-of-life communication and address how, when, and by whom such conversations are best initiated and facilitated. How guidelines are developed and what aspects of communications are included and emphasized may differ across countries related to role differences of physicians and nurses and national laws and regulations.
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J Pain Symptom Manage · Aug 2021
ReviewSugammadex to reverse neuromuscular blockade prior to withdrawal of life support.
In certain end-of-life scenarios, pharmacologic reversal of neuromuscular blockade may be indicated. However, given the depth of blockade frequently necessitated in the ICU setting, rapid reversal of neuromuscular blockade is generally not feasible with conventional reversal agents such as neostigmine that inhibit acetylcholinesterase. ⋯ We report the use of sugammadex to reverse neuromuscular blockade prior to compassionate extubation in three pediatric patients. Its clinical use in children is reviewed, potential applications in the palliative care arena discussed, and dosing algorithms presented.