[Article] Withdrawal of ventilatory support outside the intensive care unit: guidance for practice

In this paper the authors report on the experiences of a specialist paediatric palliative care team in a tertiary hospital collaborating with four different intensive care units in conducting out-of-hospital extubation. A retrospective 10 year case note review was carried out, 18 children (aged 2 weeks to 16 years) were considered.  Transfer locations included home and hospices. Planning included development of symptom management plans and emergency care plans in the event of longer than anticipated survival. The authors identified the need for local written guidance supporting healthcare professionals planning, addressing a number of key phases in the process. The authors report on the challenges such discharges present, including the practical logistics, and legal considerations that must be addressed.

Laddie, J., Craig, F., Brierley, J., Kelly, P. & Bluebond-Langner, M. 2014. Withdrawal of ventilatory support outside the intensive care unit: guidance for practice. Archives of Disease in Childhood, (99) p 812-816.

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