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- Title
Palliative Sedation Therapy Practice Comparison – A Survey of Pediatric Palliative Care and Pain Management Specialists.
- Authors
Cuviello, Andrea; Ang, Nicholas; Morgan, Kyle; Baker, Justin N.; Anghelescu, Doralina L.
- Abstract
Context : Palliative sedation therapy (PST) can relieve suffering at end-of-life (EOL) in children with intolerable and refractory symptoms. However, updated and consistent guidance on PST practices are imperative. Objectives : We investigate current variations in clinical practice and PST implementation among pediatric palliative care (PPC) and pain management (PM) specialists. Methods : We distributed an IRB-exempt electronic anonymous survey via email through the Society of Pediatric Pain Medicine, and the American Academy of Hospice and Palliative Medicine. Survey responses were collated and descriptively reported. Results : Of 83 survey responses, the majority (75%) represented large academic children's hospitals. The distribution between PPC and pediatric pain management specialists' responses was 60% and 40%, respectively. Most respondents reported having designated pain management and/or palliative care teams (70% and 90%, respectively). Approximately half (48%) reported following an institutional PST protocol, most not requiring formal ethics consult (69%). Only 54% of respondents noted that the Do Not Resuscitate (DNR) order was required prior to PST initiation. PST was primarily utilized for children with oncologic diagnoses (76%). The primary and secondary medications of choice for PST implementation were reported to be opioids (39%) and benzodiazepines (36%) by pain management specialists, and benzodiazepines (52%) and barbiturates (28%) by palliative care specialists. Conclusions : Our study highlights the variability in the practice and implementation of PST. Further educational efforts are key for establishing PST practices and efficient protocol development.
- Subjects
PROPOFOL; ANESTHESIA; ACADEMIC medical centers; RESEARCH methodology; PEDIATRICS; DO-not-resuscitate orders; COMPARATIVE studies; SURVEYS; SOCIETY of Pediatric Nurses; BENZODIAZEPINES; RESEARCH funding; OPIOID analgesics; PALLIATIVE treatment; PAIN management; MEDICAL specialties &; specialists; TRANQUILIZING drugs; BARBITURATES
- Publication
American Journal of Hospice & Palliative Medicine, 2023, Vol 40, Issue 9, p977
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/10499091221138298