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Healthcare 2019, 7(1), 3; https://doi.org/10.3390/healthcare7010003

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

1
Division of General Pediatrics, Department of Pediatrics, Sainte-Justine Hospital, Montréal, QC H3T 1C5, Canada
2
Pediatric Palliative Care Unit, Department of Pediatrics, Sainte-Justine Hospital, Montréal, QC H3T 1C5, Canada
3
Division of Pediatric Anesthesiology, Department of Pediatrics, Sainte-Justine Hospital, Montréal, QC H3T 1C5, Canada
4
Applied Clinical Research Unit, Department of Pediatrics, Sainte-Justine Hospital, Montréal, QC H3T 1C5, Canada
*
Author to whom correspondence should be addressed.
Received: 27 November 2018 / Revised: 18 December 2018 / Accepted: 20 December 2018 / Published: 2 January 2019
(This article belongs to the Special Issue Recent Advances in Palliative Care)
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Abstract

Several children receiving palliative care experience dyspnea and pain. An order protocol for distress (OPD) is available at Sainte-Justine Hospital, aimed at alleviating respiratory distress, pain and anxiety in pediatric palliative care patients. This study evaluates the clinical use of the OPD at Sainte-Justine Hospital, through a retrospective chart review of all patients for whom the OPD was prescribed between September 2009 and September 2012. Effectiveness of the OPD was assessed using chart documentation of the patient’s symptoms, or the modified Borg scale. Safety of the OPD was evaluated by measuring the time between administration of the first medication and the patient’s death, and clinical evolution of the patient as recorded in the chart. One hundred and four (104) patients were included in the study. The OPD was administered at least once to 78 (75%) patients. A total of 350 episodes of administration occurred, mainly for respiratory distress (89%). Relief was provided in 90% of cases. The interval between administration of the first protocol and death was 17 h; the interval was longer in children with cancer compared to other illnesses (p = 0.02). Data from this study support the effectiveness and safety of using an OPD for children receiving palliative care. View Full-Text
Keywords: pediatric palliative care; dyspnea; pain control; order protocol; end of life care pediatric palliative care; dyspnea; pain control; order protocol; end of life care
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Marquis, M.-A.; Daoust, L.; Villeneuve, E.; Ducruet, T.; Humbert, N.; Gauvin, F. Clinical Use of an Order Protocol for Distress in Pediatric Palliative Care. Healthcare 2019, 7, 3.

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