Managing Death in the ICU: The Transition from Cure to Comfort / Edition 1

by J. Randall Curtis, Gordon D. Rubenfeld

Overview

This volume reviews the state of the art in caring for patients dying in the ICU, focusing on both clinical aspects of managing pain and other symptoms, as well as ethical and societal issues that affect the standards of care received. The book also addresses the changing epidemiology of death in this setting related to managed care, practical skills needed to provide the highest quality of care to terminal patients, communicating with patients and families, the mechanics of withdrawing life-supporting therapies, and the essential role of palliative care specialists in the ICU. The book briefly describes unique issues that arise when caring for patients with some of the more common diseases that precipitate death in the ICU. Contributors for the book were chosen because they have experience caring for patients in the ICU and are also conducting current research to find ways of improving care for terminal patients in this setting.

Product Details

ISBN-13:	9780195128819
Publisher:	Oxford University Press, USA
Publication date:	11/24/2000
Pages:	408
Product dimensions:	9.10(w) x 5.90(h) x 1.00(d)

Table of Contents

Section I: The Changing Landscape of Death in the ICU
1. Introducing the Concept of Managing Death in the ICU, J. Randall Curtis and Gordon D. Rubenfeld
2. The Changing Ethics of Death in the ICU, Richard A. Mularski and Molly L. Osborne
3. The Changing Nature of Death in the ICU, John M. Luce and thomas J. Predergast
4. Making a Personal Relatinship with Death, Mitchell M. Levy
Section II: The Decision to Limit Life Support in the ICU
5. Outcome Pretiction in the ICU, Marin H. Kollef
6. Decision-Making and the Role of Bias, Deborah J. Cook
7. The Role of Health Status and Quality of Life in decisions about ICU Care, J. Randall Curtis and Donld L. Patrick
8. Advance Care Planning in the Outpatient and ICU Setting, Joan M. Teno
Section III: Practical Skills Needed to Manage Death in the ICU
9. How to Discuss Dying and Death in the ICU, J. Randall Curtis and Donald L. Patrick
10. Managnig Pain and other Symptoms in Dying Patients in the ICU, Kathleen Foley
11. Principles and Practice of Withdrawing Life Sustaining Treatment in the ICU, Gordon D. Rubenfeld
12. The Role of Critical Care Nurses in Providing and Managing End-of-Life Care, Kathleen Puntillo
13. Helping Families Prepare for and Cope with a Death in the ICU, Sarah E. Shannon
14. Helping the Clinician Cope with Death in the ICU, Susan D. Block
15. The Interface of Technology and Spriituality in the ICU, Nancy Chambers
16. Sacred End-of-Life Rituals in the ICU, Steven Miles
Section IV: Societal Issues
17. Role of Race, Ethnicity, Religion, and Socioeconomic Status on End-of-Life Care in the ICU, Marion Danis
18. Legal Liability Anxieties in the ICU, Marshal B. Kapp
19. Economics of Managing Death in te ICU, Peter Pronovost and Derek C. Angus
20. Organizational Change and Improving the uality of Palliative Care in the ICU, Barbara Daly
21. An International Perspective on Death in the ICU, Malcom Fisher
Section V: Specific Diseases and Special Populations
22. AIDS, Mark J. Rosen
23. Cancer, Anthony Back
24. Congestive heart failure, Jonathon Sackner-Bernstein
25. Chronic obstructive pulmonary disease, John E. Heffner
26. Decisions to limit intensive care in patients with coma, Eelco F.M. Wijdicks
27. Special concerns for infants and children, Walter M. Robinson
28. Special Concerns for the very old, Judith E. Nelson

Editorial Reviews

Reviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This multiauthored book describes the management of critical illness which becomes terminal illness in the intensive care unit.
Purpose: Articulated is a template for treating patients who do not recover from critical illness or injury. Relief of psychosocial suffering in patients and family is emphasized. Finally, practical and specific advice is given on the means to fulfill the goals of palliative care in the ICU.
Audience: The critical care fellow, attending, or teacher is an appropriate audience for this work. Authors and editors represent leading critical care programs in North America.
Features: The 28 chapters are divided into five groups. Initial chapters describe the context in which decisions to limit life support in the intensive care unit are made. Later sections help the clinician deal with feelings about death, societal input into limiting care in the intensive care unit, including the effects of race, recent legal decisions, and economic pressures. Final chapters describe end-of-life considerations for critical care practitioners dealing with patients having specific diseases, including AIDS, endstage malignancy, congestive heart failure, or chronic obstructive pulmonary disease. Chapters are clearly written with texture of type dividing major subheadings. Tables and other illustrations, as one might expect, are infrequent in a work of this kind. References allow access not only to the popular press but also legal decisions and pertinent medical literature. Medical references represent original work and date to within two years of publication.
Assessment: Due to the severity and complexity of illness in the ICU, death is common and families rate communication with healthcare providers as one of the most important skills for these individuals. This book provides background and tools which allow the intensivist to come to grips with the mortality of patients in the ICU setting.

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