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Of 15,800 observations, 1294 (8.2%) indicated discomfort with the life support plan.
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Clinicians often experience discomfort about life support plans for mechanically ventilated patients.
To examine the incidence and predictors of clinician discomfort about daily advanced life support plans for ICU patients.
Disagreements in life support treatment plans can result in moral distress among care providers.
Money must gradually be moved away from annual dollops of life support to longer-term plans for real development, with binding expectations and benchmarks.
It doesn't take a feat of imagination to see how life affirming the support planning process can be: it is not simply a means to an end.
We documented the daily plan for advanced life support and asked the bedside nurse, ICU resident and physician how comfortable they were with this plan.
The authors, on their discussion, should take advantage of this case and discuss the approach to airway extrinsic compression, the use of extra-corporeal life support (ECLS) as a back-up plan, who should be present in such situations (ENT, anaesthesia), etc… The clinician could barely secure the child's airway, and the child survived and was able to have the teratoma resected.
Potential subjects were also excluded if family or physician refused consent or if they were moribund, with planned withdrawal of life support.
Finally, due to eventual bias that would result from from including patients with a non-full code status, a sensitivity analysis excluding patients that had any life support limitation during ICU stay was planned.
Failure to plan for termination of life support, except among the infirm and elderly, is almost universal.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com