In this chapter we discuss the delivery of palliative care in the paediatric intensive care unit environment. Illustrated by challenging cases, we describe the role of intensive care in symptom management for the child with terminal or life-limiting illness. We detail the importance of a multidisciplinary team and their roles in the provision of individualised care for the child and their family. The importance of family-centred care and advance care planning is expanded upon. In addition, we explore end of life issues that are particular to children in intensive care such as withdrawal of life-sustaining therapies and organ donation. Finally, we discuss how to ensure the delivery of high-quality palliative care in the paediatric intensive care environment.
Part of the book: Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care
In this chapter, we discuss the concepts of professionalism in relation to intensive care medicine. The intensive care management of patients represents the sharp edge of every speciality and the potential for miscommunication, conflict, psychological overload and burnout is large. The presence of a culture of trust between patients and staff, and between staff members is a major factor in patient outcome, staff recruitment, staff retention and motivation. As critical care morbidity and mortality rates improve, patient and staff expectations of an acceptable short-term and long-term outcome increase. To reach these expectations, healthcare professionals need to operate in high performing teams, with defined standards and objectives. We focus on key aspects of good professional behaviour, high-performance healthcare teams and the regulatory aspects of care in the high technology, critical care environment.
Part of the book: ICU Management and Protocols