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Published on: January 27, 2023
Top Ten Tips Palliative Care Clinicians Should Know About Caring for Children in Neonatal and Pediatric Intensive
Amanda Kolmar1, Rémi M Hueckel1, Arif Kamal2
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina.
Insights
Pediatric palliative care is crucial in intensive care units due to specialist shortages. This guide offers top tips for clinicians caring for critically ill children and their families, addressing unique end-of-life care needs.
Area of Science:
- Pediatric Critical Care Medicine
- Palliative Care
- Bioethics
Background:
- Pediatric critical care units (PICUs) increasingly consult palliative care specialists.
- Limited availability of pediatric palliative care specialists necessitates broader clinician involvement.
- Unique considerations exist for critically ill children, including prognosis, family involvement, and prolonged care.
Purpose of the Study:
- To provide essential recommendations for clinicians caring for critically ill pediatric patients.
- To address common challenges in pediatric palliative care within intensive care settings.
- To offer practical guidance based on the expertise of pediatric intensive care providers.
Main Methods:
- Expert consensus and clinical experience from pediatric intensive care providers.
- Development of a "top 10 tips" list for palliative care in PICUs.
- Focus on practical considerations for managing complex pediatric cases.
Main Results:
- Key recommendations cover prognosis, child life services, therapy integration (music, pet), parental involvement in rituals, sibling care, medical technology use, and managing extended hospital stays.
- The tips address the multifaceted needs of infants, children, and adolescents with serious illnesses.
- Guidance is provided for supporting families throughout the critical care journey.
Conclusions:
- Palliative care integration is vital in pediatric intensive care.
- Clinicians require specific guidance to navigate the complexities of pediatric end-of-life care.
- These recommendations aim to improve the quality of care for critically ill children and their families.
Abstract:
Over the past several years, pediatric critical care units increasingly count on the expert advisement of palliative care specialists. Given the limited availability of pediatric palliative care specialists, all palliative care clinicians may be required to care for pediatric patients and their families. Special considerations in caring for these patients include the relative importance of prognosis, involvement of child life, music and pet therapy, incorporation of parents in end-of-life rituals, care for siblings, use of medical technology, and prolonged duration of stay. The following top 10 tips provide recommendations for caring for seriously ill infants, children, adolescents, and the families of these critically ill pediatric patients. They are written by pediatric intensive care providers to address common issues around palliative care in intensive care units.
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