ICU learning pathway | Dying in Intensive Care

Dying in intensive care
Session overview
Description
This session uses a case history to examine some of the challenges in providing end of life care in intensive care units (ICUs). Determining the appropriate ceiling of intervention, changing the focus of care from cure to comfort, communication issues, supporting patients and families and pain and symptom control issues will be discussed.

By the end of this session you will be able to:

• describe the key issues and challenges facing dying patients and their families in an ICU setting
• describe triggers to conversations about end of life care in ICU and explain how these conversations may be approached
• recognise the signs and symptoms that indicate that treatment may be becoming futile in dying patients in ICU
• explain how decisions about ceiling of intervention may be made
• outline a sensible approach to managing end of life care for patients in an ICU situation

Intensive care units (ICUs) can be frightening places for patients and their families. When treatment becomes futile, the focus of care shifts. Providing care and support for patients and families in this situation can be challenging.

Determining the appropriate levels of medical intervention, recognising when a patient is dying, initiating conversations and decision making about end of life care require skills and sensitivity. Assessing and controlling pain and symptoms in unconscious patients can be difficult.

Through a case study, this session offers some strategies for approaching such clinical situations, illustrates some of the challenges and highlights points for further learning and reflection.