A letter with so strinking title has been recently published in Intensive Care Medicine, and it refers to another article commented in this blog by Bárbara Salas: Ten key points about ICU palliative care.
Drs. Zante and Schefold from Bern University Hospital ICU, pose to the authors a necessary reflection given the characteristics that differentiate ICU from the palliative care outside ICU. They argue that these patients and their families often have had a long time of reflection and relationship with their situation at the end of life, unlike when one person is admitted in the ICU, when a sudden change in the situation happends. In fact, they share an article in which there were no diferences in the incidence of anxiety or depression when the relationship with the family was headed by a specialist in palliative or ICU care. However, they point to a comprehensive mix model should be our future.
In any case, proper preparation and training is imperative for any intensive care professional, although most of the ICU does not have these training programmes where communication is key to ease the grief and possible post-traumatic stress disorder.
Here are the ten key points:
1. “Palliative care is relevant for all critically ill patients”.
2. “Palliative care is the responsibility of all clinicians in the ICU”
3. “ICU clinicians can and are obliged to ensure patient comfort at the end of life”
4. “A decision to allow a natural death does not by itself mean that comfort is the patient’s exclusive goal or that intensive care interventions should be withheld/withdrawn”
5. “Critical illness and intensive care have profound impact on families as well as patients”
6. “Palliative care can support ICU clinicians who experience moral or psychological distress in the course of caring for patients”
7. “Educational resources and clinical tools are available to support delivery of high-quality palliative care in the ICU”
8. “The ICU nurse plays a crucial role in palliative care including communication between the health care team and the patient/family”
9. “The quality of ICU palliative care can be measured”
10. “High-quality ICU palliative care can improve ICU metrics and patient-oriented outcomes.
In this sense, Enric Benito is actively working with Proyecto HU-CI by knowing the ICU of Hospital Universitario de Son Espases with the target of researching in #cuidadospaliativosintensivos (palliative intensive care). He is going to present the first results at #3JHUCI next May in Granada.