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Clinical Use of an Order Protocol for Distress in Pediatric Palliative Care

Marc-Antoine Marquis1, Lysanne Daoust2, Edith Villeneuve3

  • 1Division of General Pediatrics, Department of Pediatrics, Sainte-Justine Hospital, Montréal, QC H3T 1C5, Canada. marc-antoine.marquis@umontreal.ca.

Healthcare (Basel, Switzerland)
|January 6, 2019
PubMed

Insights

The Order Protocol for Distress (OPD) effectively managed respiratory distress, pain, and anxiety in pediatric palliative care patients. This protocol demonstrated safety and significant symptom relief in 90% of cases.

Area of Science:

  • Pediatric Palliative Care
  • Clinical Pharmacology
  • Symptom Management

Background:

  • Children in palliative care often suffer from distressing symptoms like dyspnea and pain.
  • The Order Protocol for Distress (OPD) was developed to manage these symptoms in pediatric palliative care.

Purpose of the Study:

  • To evaluate the clinical effectiveness and safety of the Order Protocol for Distress (OPD).
  • To assess the OPD's impact on symptom relief and patient outcomes in pediatric palliative care.

Main Methods:

  • Retrospective chart review of 104 pediatric patients who received the OPD between 2009 and 2012.
  • Effectiveness assessed via symptom documentation and modified Borg scale; safety evaluated by time-to-death and clinical evolution.

Main Results:

  • The OPD was administered to 75% of patients, primarily for respiratory distress (89%).
  • Symptom relief was achieved in 90% of administrations.
  • The interval between first OPD administration and death was 17 hours, longer in cancer patients (p=0.02).

Conclusions:

  • The Order Protocol for Distress (OPD) is an effective and safe intervention for managing symptoms in pediatric palliative care.
  • The OPD significantly alleviates respiratory distress, pain, and anxiety, improving patient quality of life.

Keywords:
dyspneaend of life careorder protocolpain controlpediatric palliative care

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