End-of-life care in patients with a highly transmissible respiratory virus: implications for COVID-19
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REVIEW ARTICLE/BRIEF REVIEW
End-of-life care in patients with a highly transmissible respiratory virus: implications for COVID-19 Soins de fin de vie pour les patients atteints d’un virus respiratoire extreˆmement transmissible : implications pour la COVID-19 . Ariel Hendin, MD, FRCPC . Lisa Fischer, MD, FRCPC . Miriam Mottiar, MD, MHSc, FRCPC Amanda Roze des Ordons, MD, MEd, FRCPC . Michael Hartwick, MD, MEd, FRCPC Received: 26 April 2020 / Revised: 29 April 2020 / Accepted: 30 April 2020 Ó Canadian Anesthesiologists’ Society 2020
Abstract Symptom management and end-of-life care are core skills for all physicians, although in ordinary times many anesthesiologists have fewer occasions to use these skills. The current coronavirus disease (COVID-19) pandemic has caused significant mortality over a short time and has necessitated an increase in provision of both critical care and palliative care. For anesthesiologists deployed to units caring for patients with COVID-19, this narrative review provides guidance on conducting goals of care discussions, withdrawing life-sustaining measures, and managing distressing symptoms.
M. Mottiar, MD, MHSc, FRCPC (&) Department of Anesthesiology & Pain Medicine, Division of Palliative Medicine, Department of Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd, Room 1401, Ottawa, ON K1H 8L6, Canada e-mail: [email protected] A. Hendin, MD, FRCPC Department of Emergency Medicine, Division of Critical Care, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada L. Fischer, MD, FRCPC Department of Emergency Medicine, Division of Palliative Medicine, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada A. Roze des Ordons, MD, MEd, FRCPC Department of Anesthesiology, Perioperative and Pain Medicine, Department of Critical Care Medicine, Division of Palliative Medicine, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada M. Hartwick, MD, MEd, FRCPC Division of Critical Care, Division of Palliative Medicine, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
ˆ mes et les soins de Re´sume´ La prise en charge des sympto fin de vie sont des compe´tences de base pour tous les me´decins, bien qu’en temps ordinaire, de nombreux anesthe´siologistes n’ont que peu d’occasions de mettre en pratique ces compe´tences. La pande´mie actuelle de coronavirus 2019 (COVID-19) a provoque´ un taux de mortalite´ significatif dans un court intervalle et a ne´cessite´ une augmentation des besoins en soins intensifs et en soins palliatifs. Destine´ aux anesthe´siologistes de´ploye´s dans les unite´s prenant soin de patients atteints de la COVID-19, ce compte rendu narratif offre des recommandations quant a` la fac¸on de mener les discussions a` propos des objectifs de soins, du retrait des the´rapies de soutien vital, et de la prise ˆ mes de de´tresse. en charge de sympto
Cases of coronavirus disease (COVID-19) were first reported in December 2019 in Hubei province in China and the il
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