ETIK2016 - Afklaring af patienternes ønsker. Kan vi lære noget af amerikanerne?Mads Astvad
Hanne Irene Jensen, sygeplejerske, PhD, postdoc, foredrager om erfaringer med protokolleret afklaring af patienters ønsker mod slutning af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
ETIK2016 - Fravalg af livsforlængende behandling. Hvad skal vi? Hvad må vi?Mads Astvad
Hans-Henrik Bülow, forskningsansvarlig overlæge, Holbæk Sygehus, foredrager om etiske og juridiske forhold omkring behandling af patienter i den sidste del af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
ETIK2016 - Kan intensivpatienter få lov til at dø hjemme?Mads Astvad
Lisa Seest Nielsen, overlæge intensiv afdeling, Kolding, beretter om erfaringer med hjælpe uhelbredeligt, kritisk syge patienter hjem med at kunne dø i eget hjem.
Foredrag fra ETIK2016. Se videooptagelse: http://scanfoam.org/etik2016.
ETIK2016 - En værdig afslutning på livet. Den praktiserende læges rolleMads Astvad
Bruno Melgaard, nyligt afgået formand for PLO, foredrager om primærsektorens rolle hos patienter i den sidste fase af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
Hvad gør vi hos os, når patienten er døende? | 5 fagfolk beretter | ETIK2018scanFOAM
Oplæg fra 5 fagprofessionelle, som hver i deres virke må forholde sig til mennesket i livets afslutning.
- Lotte Blicher Mørk, præst, Rigshospitalet
- Klaus Østergaard-Nielsen, praktiserende læge, Vejle
- Elly Boddum, hospicesygeplejerske, Ankerfjord, Hvide Sande
- Kjeld Erik Otte, overlæge, dialyseafsnittet, Kolding sygehus
- Annette Junker, projektleder, Varde Kommune
Fuld video af denne og resten af dagens sessioner på
https://scanfoam.org/etik2018
ETIK2016 - Afklaring af patienternes ønsker. Kan vi lære noget af amerikanerne?Mads Astvad
Hanne Irene Jensen, sygeplejerske, PhD, postdoc, foredrager om erfaringer med protokolleret afklaring af patienters ønsker mod slutning af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
ETIK2016 - Fravalg af livsforlængende behandling. Hvad skal vi? Hvad må vi?Mads Astvad
Hans-Henrik Bülow, forskningsansvarlig overlæge, Holbæk Sygehus, foredrager om etiske og juridiske forhold omkring behandling af patienter i den sidste del af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
ETIK2016 - Kan intensivpatienter få lov til at dø hjemme?Mads Astvad
Lisa Seest Nielsen, overlæge intensiv afdeling, Kolding, beretter om erfaringer med hjælpe uhelbredeligt, kritisk syge patienter hjem med at kunne dø i eget hjem.
Foredrag fra ETIK2016. Se videooptagelse: http://scanfoam.org/etik2016.
ETIK2016 - En værdig afslutning på livet. Den praktiserende læges rolleMads Astvad
Bruno Melgaard, nyligt afgået formand for PLO, foredrager om primærsektorens rolle hos patienter i den sidste fase af livet.
Oplæg ved ETIK2016. Kan ses og høres her:
http://scanfoam.org/etik2016/
Hvad gør vi hos os, når patienten er døende? | 5 fagfolk beretter | ETIK2018scanFOAM
Oplæg fra 5 fagprofessionelle, som hver i deres virke må forholde sig til mennesket i livets afslutning.
- Lotte Blicher Mørk, præst, Rigshospitalet
- Klaus Østergaard-Nielsen, praktiserende læge, Vejle
- Elly Boddum, hospicesygeplejerske, Ankerfjord, Hvide Sande
- Kjeld Erik Otte, overlæge, dialyseafsnittet, Kolding sygehus
- Annette Junker, projektleder, Varde Kommune
Fuld video af denne og resten af dagens sessioner på
https://scanfoam.org/etik2018
Her kan du se en præsentation med de erfaringer, som de to sygeplejersker Liselotte Langelund og Lene Kjær fik på deres tur til Great Ormond Street Hospital i Løndon. Det er det materiale, som de har brugt til at videreformidle deres erfaringer til deres kolleger efter. har brugt til at undervise
Charlotte Ibsen, Hvidovre Hospital - Bruger Inddragelse, det nye sort...koradk
Charlotte Ibsen er klinisk oversygeplejerske på Hvidovre Hospital og arbejder også med brugerinddragelse. Men i 2014 blev hun ramt af brystkræft og oplevede dermed brugerinddragelse fra patientens synsvinkel. Hun fortæller om den oplevelse, og hvordan hun bruger den i sit arbejde i dag.
Reframing shock physiology - a tale of 3 pressures - Sara Crager - TBS24scanFOAM
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Manual pressure augmentation in OHCA - David Anderson - TBS24scanFOAM
This document summarizes a presentation on manual pressure augmentation (MPA) for out-of-hospital cardiac arrest. MPA involves a paramedic applying firm, even pressure over electrode pads or paddles during defibrillation attempts to potentially improve current delivery to the heart. The presentation reviewed prior studies showing MPA improved defibrillation success for atrial fibrillation. It proposed a new study called AUGMENT-VA to evaluate if MPA could also benefit patients in ventricular fibrillation/ventricular tachycardia. The trial would randomize paramedics to provide standard care or MPA in addition to standard care during cardiac arrest resuscitation efforts, with the goal of improving survival to hospital discharge rates.
Scalpels and Stories - rediscoverin narrative in medicinen - Matt Morgan - TBS24scanFOAM
This patient has a rare blood disorder called TTP and is at high risk of infection due to immunosuppressant treatments. While starting a new treatment, the medical team will closely monitor for infection given other health issues. A tracheostomy may be needed to help breathing but will only be considered carefully over the next week based on the patient's condition and risks versus benefits. The team is very concerned about the patient's frailty and limited chances of survival due to the disease and prior health.
Whole blood for trauma haemorrhage - UK experience - Laura Green - TBS24scanFOAM
Whole Blood for Trauma Haemorrhage: UK experience
1) A study in the UK found that using a component of red blood cells and plasma (RCP) in pre-hospital trauma patients reduced wastage and had similar clinical outcomes compared to separate red blood cells and plasma.
2) This led to the development of a whole blood program and component to evaluate the potential benefits of whole blood transfusion in the pre-hospital setting.
3) The SWIFT trial is now underway, randomly assigning severely injured trauma patients to receive either two units of whole blood or two units of red blood cells and plasma to determine if whole blood transfusion leads to reduced mortality or need for massive transfusion.
TBI and CV dysfunction - Flora Bird - TBS24scanFOAM
Traumatic brain injury (TBI) is a major global health problem and the leading cause of death and disability in people under 40 in many countries. Approximately 24% of patients with severe isolated TBI experience cardiovascular dysfunction prior to physician-led emergency helicopter assessment. These patients have lower GCS, higher heart rate and lactate, and worse coagulopathy compared to those without cardiovascular dysfunction. They also require more blood transfusions, have higher mortality, and are less likely to be discharged home. Further research is needed to better understand the pathophysiology of cardiovascular dysfunction following severe TBI in order to improve recognition and treatment in the critical hyperacute phase after injury.
The document appears to be a slide presentation on using point-of-care ultrasound (POCUS) in emergency settings. It includes multiple poll questions, ultrasound images, and case descriptions of various trauma and medical patients where POCUS could be used to aid in diagnosis and treatment. Key information discussed includes using POCUS to identify pneumothorax, pericardial effusions, aortic abnormalities, and free fluid in trauma and obstetric patients. The importance of POCUS for volume assessment, guiding procedures, and detecting complications is also highlighted through several case examples.
How kissing a frog can save your life - Matt Morgan - TBS24scanFOAM
This short document discusses how kissing a frog can save your life by encouraging learning in different departments and upholding one oath. It suggests that being open-minded and exploring new ideas, as the fairy tale implies by kissing the frog, can lead to personal growth and development across different areas of life and work.
Fully Automated CPR - van der Velde - TBS"4scanFOAM
Dr. Jason van der Velde conducted an observational study on advanced respiratory support techniques for managing hypoxia and hypercarbia during cardiac arrest situations. The objectives of his presentation were to provide excessive detail and promote his own findings, criticize current practices, add unnecessary complexity to guidelines, present opinions as facts, ignore best practices for presentations, and go significantly over time.
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24scanFOAM
This document discusses expanding the use of extracorporeal cardiopulmonary resuscitation (ECPR) for cardiac arrest patients. It examines current guidelines on patient selection criteria and outlines a proposed collaborative model for pre-hospital ECPR delivery. This model involves advanced paramedics performing roadside cannulation to begin ECPR within 10 minutes of arrest. It also discusses developing common training standards, clinical governance structures, and telemedicine support to safely implement a pre-hospital ECPR system across multiple centers. The goal is to establish earlier ECPR access for select cardiac arrest patients.
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...scanFOAM
This document discusses mechanical ventilation strategies for pediatric acute respiratory distress syndrome (PARDS). It provides definitions for mild, moderate, and severe PARDS based on oxygenation index (OI) and oxygen saturation index (OSI) values. It recommends using a lung protective ventilation bundle with low tidal volumes, plateau pressures below 28 cm H2O or 32 cm H2O in cases of reduced chest wall compliance, positive end-expiratory pressure (PEEP) according to a PEEP/FiO2 table, and limiting driving pressure to 15 cm H2O. The document also discusses challenges with adherence to these guidelines in clinical practice and potential solutions like computerized decision support tools.
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...scanFOAM
This document summarizes the lengthy process to become an ESA astronaut candidate. It involves submitting an application with credentials and experience meeting strict criteria. If selected, candidates undergo psychological tests, medical tests, and technical and professional interviews. From the initial applicants, only about 17 are selected for the final training cohort. The document emphasizes that the role requires strong teamwork, risk tolerance, and emotional stability to handle the challenges of space travel.
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...scanFOAM
Will Smith is an expert in unmanned aerial systems and their increasing role in search and rescue operations. He discussed terminology related to drones, different drone platforms that could be used for SAR including their capabilities and limitations. He covered regulations and certifications required as well as concepts for how drones could be deployed for various SAR missions like lost person searches, mass casualty incidents, and avalanches. Partnerships between SAR teams and those with drone expertise will be important to establish effective drone programs for improving SAR response capabilities.
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...scanFOAM
This document outlines an integrated emergency care simulation programme that uses immersive simulation to train healthcare professionals. It discusses using realistic scenarios, environments, equipment and live actors to create challenging simulations that move beyond traditional skills stations. The goal is to improve learners' technical skills as well as their non-technical skills like leadership, communication and emotional intelligence. Examples provided include simulations of trauma resuscitation, complex medical emergencies, and disaster scenarios to fully immerse learners in realistic high-pressure situations.
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24scanFOAM
The document discusses a teleconference between NASA officials about whether to launch the Space Shuttle Challenger on January 27, 1986. It notes the timing of the teleconference and includes quotes from the discussion. It then analyzes why the decision was made to launch, despite concerns about the weather, citing issues like groupthink, desire for conformity, intolerance of dissent, and deference to perceived expertise. The document suggests these group dynamics may have prevented an objective evaluation of the risks.
Precision in neonatal transport - Ian Braithwaite - TBS24scanFOAM
This document discusses precision in neonatal transport. It notes that tight control of PaCO2 and oxygen saturation is important during transport. Data shows the percentage of transports where PaCO2 was outside the target range of 4-7 kPa has decreased in recent years. Medication delivery also requires precision, and various factors like pump orientation and syringe size can affect stability. The physical forces involved in transport like shocks, vibrations and accelerations are defined, and data shows ambulance transports experience more impulsive events than helicopters. Precision is important throughout the entire transport journey.
More Related Content
Similar to Hvad gør vi hos os, når patienten er døende? | Kjeld Erik Otte @ #ETIK2018
Her kan du se en præsentation med de erfaringer, som de to sygeplejersker Liselotte Langelund og Lene Kjær fik på deres tur til Great Ormond Street Hospital i Løndon. Det er det materiale, som de har brugt til at videreformidle deres erfaringer til deres kolleger efter. har brugt til at undervise
Charlotte Ibsen, Hvidovre Hospital - Bruger Inddragelse, det nye sort...koradk
Charlotte Ibsen er klinisk oversygeplejerske på Hvidovre Hospital og arbejder også med brugerinddragelse. Men i 2014 blev hun ramt af brystkræft og oplevede dermed brugerinddragelse fra patientens synsvinkel. Hun fortæller om den oplevelse, og hvordan hun bruger den i sit arbejde i dag.
Reframing shock physiology - a tale of 3 pressures - Sara Crager - TBS24scanFOAM
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Manual pressure augmentation in OHCA - David Anderson - TBS24scanFOAM
This document summarizes a presentation on manual pressure augmentation (MPA) for out-of-hospital cardiac arrest. MPA involves a paramedic applying firm, even pressure over electrode pads or paddles during defibrillation attempts to potentially improve current delivery to the heart. The presentation reviewed prior studies showing MPA improved defibrillation success for atrial fibrillation. It proposed a new study called AUGMENT-VA to evaluate if MPA could also benefit patients in ventricular fibrillation/ventricular tachycardia. The trial would randomize paramedics to provide standard care or MPA in addition to standard care during cardiac arrest resuscitation efforts, with the goal of improving survival to hospital discharge rates.
Scalpels and Stories - rediscoverin narrative in medicinen - Matt Morgan - TBS24scanFOAM
This patient has a rare blood disorder called TTP and is at high risk of infection due to immunosuppressant treatments. While starting a new treatment, the medical team will closely monitor for infection given other health issues. A tracheostomy may be needed to help breathing but will only be considered carefully over the next week based on the patient's condition and risks versus benefits. The team is very concerned about the patient's frailty and limited chances of survival due to the disease and prior health.
Whole blood for trauma haemorrhage - UK experience - Laura Green - TBS24scanFOAM
Whole Blood for Trauma Haemorrhage: UK experience
1) A study in the UK found that using a component of red blood cells and plasma (RCP) in pre-hospital trauma patients reduced wastage and had similar clinical outcomes compared to separate red blood cells and plasma.
2) This led to the development of a whole blood program and component to evaluate the potential benefits of whole blood transfusion in the pre-hospital setting.
3) The SWIFT trial is now underway, randomly assigning severely injured trauma patients to receive either two units of whole blood or two units of red blood cells and plasma to determine if whole blood transfusion leads to reduced mortality or need for massive transfusion.
TBI and CV dysfunction - Flora Bird - TBS24scanFOAM
Traumatic brain injury (TBI) is a major global health problem and the leading cause of death and disability in people under 40 in many countries. Approximately 24% of patients with severe isolated TBI experience cardiovascular dysfunction prior to physician-led emergency helicopter assessment. These patients have lower GCS, higher heart rate and lactate, and worse coagulopathy compared to those without cardiovascular dysfunction. They also require more blood transfusions, have higher mortality, and are less likely to be discharged home. Further research is needed to better understand the pathophysiology of cardiovascular dysfunction following severe TBI in order to improve recognition and treatment in the critical hyperacute phase after injury.
The document appears to be a slide presentation on using point-of-care ultrasound (POCUS) in emergency settings. It includes multiple poll questions, ultrasound images, and case descriptions of various trauma and medical patients where POCUS could be used to aid in diagnosis and treatment. Key information discussed includes using POCUS to identify pneumothorax, pericardial effusions, aortic abnormalities, and free fluid in trauma and obstetric patients. The importance of POCUS for volume assessment, guiding procedures, and detecting complications is also highlighted through several case examples.
How kissing a frog can save your life - Matt Morgan - TBS24scanFOAM
This short document discusses how kissing a frog can save your life by encouraging learning in different departments and upholding one oath. It suggests that being open-minded and exploring new ideas, as the fairy tale implies by kissing the frog, can lead to personal growth and development across different areas of life and work.
Fully Automated CPR - van der Velde - TBS"4scanFOAM
Dr. Jason van der Velde conducted an observational study on advanced respiratory support techniques for managing hypoxia and hypercarbia during cardiac arrest situations. The objectives of his presentation were to provide excessive detail and promote his own findings, criticize current practices, add unnecessary complexity to guidelines, present opinions as facts, ignore best practices for presentations, and go significantly over time.
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24scanFOAM
This document discusses expanding the use of extracorporeal cardiopulmonary resuscitation (ECPR) for cardiac arrest patients. It examines current guidelines on patient selection criteria and outlines a proposed collaborative model for pre-hospital ECPR delivery. This model involves advanced paramedics performing roadside cannulation to begin ECPR within 10 minutes of arrest. It also discusses developing common training standards, clinical governance structures, and telemedicine support to safely implement a pre-hospital ECPR system across multiple centers. The goal is to establish earlier ECPR access for select cardiac arrest patients.
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...scanFOAM
This document discusses mechanical ventilation strategies for pediatric acute respiratory distress syndrome (PARDS). It provides definitions for mild, moderate, and severe PARDS based on oxygenation index (OI) and oxygen saturation index (OSI) values. It recommends using a lung protective ventilation bundle with low tidal volumes, plateau pressures below 28 cm H2O or 32 cm H2O in cases of reduced chest wall compliance, positive end-expiratory pressure (PEEP) according to a PEEP/FiO2 table, and limiting driving pressure to 15 cm H2O. The document also discusses challenges with adherence to these guidelines in clinical practice and potential solutions like computerized decision support tools.
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...scanFOAM
This document summarizes the lengthy process to become an ESA astronaut candidate. It involves submitting an application with credentials and experience meeting strict criteria. If selected, candidates undergo psychological tests, medical tests, and technical and professional interviews. From the initial applicants, only about 17 are selected for the final training cohort. The document emphasizes that the role requires strong teamwork, risk tolerance, and emotional stability to handle the challenges of space travel.
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...scanFOAM
Will Smith is an expert in unmanned aerial systems and their increasing role in search and rescue operations. He discussed terminology related to drones, different drone platforms that could be used for SAR including their capabilities and limitations. He covered regulations and certifications required as well as concepts for how drones could be deployed for various SAR missions like lost person searches, mass casualty incidents, and avalanches. Partnerships between SAR teams and those with drone expertise will be important to establish effective drone programs for improving SAR response capabilities.
Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halde...scanFOAM
This document outlines an integrated emergency care simulation programme that uses immersive simulation to train healthcare professionals. It discusses using realistic scenarios, environments, equipment and live actors to create challenging simulations that move beyond traditional skills stations. The goal is to improve learners' technical skills as well as their non-technical skills like leadership, communication and emotional intelligence. Examples provided include simulations of trauma resuscitation, complex medical emergencies, and disaster scenarios to fully immerse learners in realistic high-pressure situations.
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24scanFOAM
The document discusses a teleconference between NASA officials about whether to launch the Space Shuttle Challenger on January 27, 1986. It notes the timing of the teleconference and includes quotes from the discussion. It then analyzes why the decision was made to launch, despite concerns about the weather, citing issues like groupthink, desire for conformity, intolerance of dissent, and deference to perceived expertise. The document suggests these group dynamics may have prevented an objective evaluation of the risks.
Precision in neonatal transport - Ian Braithwaite - TBS24scanFOAM
This document discusses precision in neonatal transport. It notes that tight control of PaCO2 and oxygen saturation is important during transport. Data shows the percentage of transports where PaCO2 was outside the target range of 4-7 kPa has decreased in recent years. Medication delivery also requires precision, and various factors like pump orientation and syringe size can affect stability. The physical forces involved in transport like shocks, vibrations and accelerations are defined, and data shows ambulance transports experience more impulsive events than helicopters. Precision is important throughout the entire transport journey.
Mantas Okas - where do we come from and where can we go if we feel like?scanFOAM
This document discusses the importance of stress management training for medical students. It describes a 2-week course called "The Inevitable Stress" that teaches stress management through simulation exercises. The course focuses on developing emotional intelligence, awareness of one's stress responses, and practical skills to handle stress. Student feedback praised the highly relevant content, opportunity to strengthen skills, and safe learning environment. The document argues that stress management training should be a mandatory and ongoing part of the medical school curriculum to create doctors who can handle stress and work better, improving patient care.
The document discusses the benefits of exercise for both physical and mental health. It notes that regular exercise can reduce the risk of diseases like heart disease and diabetes, improve mood, and reduce feelings of stress and anxiety. Staying active also helps maintain a healthy weight and keeps muscles, bones, and joints healthy as we age.
A talk by Sara Crager at TBS24
Shock isn’t about hypotension, it’s about hypoperfusion. While we know this in theory, we don’t do a great job of applying it in practice. In order to move beyond our reliance on blood pressure to recognize shock at the bedside, we need to stop thinking about shock as a diagnosis and instead think about it as a continuum.
Fully Automated CPR | Jason van der Velde | TBS24scanFOAM
Embark on a fascinating exploration of Fully Automated Cardiac Arrest Management with Dr. Jason van der Velde, who’s been part of a team refining the FA-CPR algorithm since 2019. Gain unique insights into real-world applications and ongoing research opportunities in optimising the “Low Flow State” through innovative approaches like Chest Compression Synchronised Ventilation (CCSV). Dr. Van der Velde shares an iterative journey, supported by real-life data, underscoring the profound impact of personalised CPR tailored to individual patients in rural Ireland. The talk goes beyond conventional guidelines, delving into the intricate science and human factors essential for achieving substantial improvements in Return of Spontaneous Circulation (ROSC) rates. Attendees will leave with a deep understanding of the potential of Fully Automated CPR with CCSV as a dynamic and continually evolving strategy, acting as a strategic placeholder to buy essential time for comprehensive diagnostics and personalised interventions. The presentation hints at transformative possibilities in resuscitation science, featuring case studies that showcase the concept of bridging patients to definitive interventions such as cardiac angiography and Extracorporeal Membrane Oxygenation (ECMO).
The future of the emergency room | Jean-Louis Vincent at TBS23scanFOAM
This document discusses the future of emergency medicine and intensive care. It suggests that emergency departments will see both smaller and larger patient populations as telemedicine and home care become more prevalent, allowing efficient comprehensive management. Specialists, labs, imaging, and AI will play larger roles. Triage and disposition may be aided by AI, and the roles of ER, ICU, and specialists will evolve in an integrated hospital network supported by telemedicine. Data standardization, large databases, and AI/machine learning can help provide personalized care and evaluate new therapies.
3. Nyrekursus
• Creat. Cl. < 30 ml/min.
• 6 sessioner af 4 timer.
• Hvordan man lever med nyresygdom.
• Hvilken behandling man kan få.
4. MMU
• Behandling uden dialyse eller transplantation
• Man har som patient ret til at fravælge
behandling.
• Kan vælges før terminal nyresvigt.
• Kan vælges under dialysebehandling.
• Den skrøbelige patient, der nærmer sig livets
afslutning.
5. Valg af MMU
• Fortsat kontrol
• Kontaktsygeplejerske og kontaktlæge tager
stadig hånd om dig og din behandling.
• Den medicinske behandling opretholdes og
justeres i forhold til dine symptomer.
• Vi vil hele tiden hjælpe med lindring, støtte og
opbakning.
• På et tidspunkt vil du dø af det.
6. MMU
• En planlagt, holistisk patientcentreret
behandling af patienter med terminal
nyresvigt.
7. MMU
• Aktiv konservativ strategi.
• Mange elementer til fælles med palliativ
behandling – ikke forbeholdt døende
patienter.
• Lever ofte lige så længe.
• Færre invasive procedurer og indlæggelser.
• Pris for dialyse: Nedsat livskvalitet.
8. Valg når døden nærmer sig
• Hjemme
• Hospice
• Sygehusafdeling
9. Case
• 80 årig mand, arkitekt, rask ægtefælle, 3 børn,
5 børnebørn, 1 oldebarn.
• Nyresvigt på baggrund af hypertension.
• Mangeårigt forløb, de sidste 4 år i
hæmodialyse.
10. Afslutter behandlingen
• Opereret for cancer recti for 13 år siden.
• Frisk blod i stomien.
• Pus i rectumstumpen.
• Organkirurgerne tilbyder udredning.
• Orker ikke et nyt forløb.
11. Forløb
• Familien støtter op om beslutningen.
• Dialysen afsluttes.
• Enestue på sengeafdelingen.
• Ægtefælle/datter medindlægges.
12. Citater fra journalen
• Som vanligt godt humør, friske bemærkninger,
afklaret med sin situation.
• Yderst veltilpas, strålede som en sol, da han
spiste nye danske kartofler (april) med sin
familie.
• Familien kommer med østers til frokost, meget
glad i dag.
• Har i dag fået østers og champagne.
13. Journalcitater cont.
• Spørger om han skal dø i dag.
• Glæder sig til kaviar som familien kommer
med i dag.
• Kræfterne svinder, hjælp til forflytninger.
• Smertedækket med oxynorm x 4 dagl.
• Sover stille ind.