The idea is that the end of the life can be associated with a superficial burden or refractory is something that is present in society. Y, more so than the girl, the desire to die without supremacy is all legitimate that, for sure, there is an effective medical response to what we know as palliative sedation, a sedation that has no relationship with euthanasia.
This article contains scientific works that revise the palliative sedation in Europe in prospective studies and meet the criteria for evaluating the quality of sedation.
These works are based on a consensus document on the conceptual market and terminology of palliative care in the final of the year, which is marked in a project of the European Union, and in which German research groups participate, Belgium, Spain, the Netherlands, Hungary, Italy and the United Kingdom.
What is the palliative sedation?
Palliative care is a medical intervention intended to eliminate the “refractory supremacy” at the end of life. It mediates the proportional and controlled staff of destined pharmacists to reduce patient conscience.
This palliative sedation can be continuous or intermittent, deep or light. Therefore, a palliative sedation does not always require that the patient is deeply drowsy: he can be asleep and also can apply during a specific time if he has reached an adequate level and in this way he will live.
But in general the sedation that is applied is deep, continuous and maintained in order to alleviate the suffering until the patient falls. Hecho, the clinical context of a palliative sedation is always the end of the life and the clinical guises suggest as a condition that they consider a prognosis -y, therefore, a duration of the inferior sedation- in two weeks.
The object of palliative sedation is aliviar, to the extent that this sedation must always be proportional to the necessary alivio. This palliative sedation is different from the somnolence produced by some pharmacists that are used for the patient to descend or to be treated as a secondary effect of analgesics such as morphine and its derivatives.
Palliative care is not a means to accelerate the death of the patient, nor is it a direct practice to fill in the gaps of not being aware of the end of the life without refractory symptoms or a severe anguish. Tampoco is filled with sedation to alleviate the pain of families or the burden of work or the care of the elderly
What is the “refractory supremacy”?
To consider a palliative sedation, members of an assisted living team should have added to the conviction that there are no other treatment options that can provide an adequate level of time and unacceptable adverse effects. Find the rank of acceptable time is something shared between the team and the patient.
It is precisely that this team has experience in palliative care and that it has carried out a multidimensional evaluation of the situation. Hecho, with frequency, the patient reaches a level adequate thanks to the attention and the means of this expert team.
The ability to align this level also influences the tolerance of supremacy, depending on personal, social and cultural factors. This tolerance for pain or superstition also affects the preferences and desires of the person.
The palliative care is implemented when considering that the only remedy available to alleviate the patient’s situation. In this context, refractory supremacy is what can be accomplished with the work of an expert team in multidisciplinary palliative care at a sufficient time. The notion of refractoriness can be applied to a single syndrome or, more habitually, to a set of syndromes that the patient experiences as onontbeerlik.
Who decides on the condition of intolerance?
The decision to carry out a palliative sedation is based on a combined process of making decisions shared between the patient and a team of palliative care experts. In short, the patient is the one who determines that the problem is unbearable and the team that determines that is refractory.
What are the symptoms of suelen being implicated in what is called refractory supremacy?
At the end of the day there are situations that can potentially be refractory such as delirium (agitated delirium), disne, pain, continuous vomiting, convulsions… Some of them can be presented with authentic authentic. It is the case of massive hemorrhages, terminal respiratory failure or the crisis of pain that suelen requires an urgent palliative sedation.
How to evaluate the effectiveness of palliative care?
The method of evaluating the efficacy of palliative sedation is the quality of comfort referred to by the patient, if not possible, the depth of the sedation and the degree of tranquility that is perceived in the patient. There are objective questioners and escalators who value the degree of malpractice including a person who can not be expressed, to be central to the expression of the rostrum, the quietness of respiration or the level of relaxation. In summary, professionals are at the forefront of the level of comfort in nursing that is about to fail.
The “existential supremacy” as an exceptional situation for palliative care
The palliative care occupies also the existential dimension of the surface. This existential supremacy can present as a loss of meaning and proposition in life, help with death, impotence, desperation and desperation, perception of loss of dignity, sensation of abandonment or simply feeling like cara.
It is only possible to walk alone in the terminals, but you can express yourself with a lot more force when a person enters the final of the life. Sondeverbod, only in exceptional cases the existential supremacy appears as one reason for the palliative sedation. It is much more frequent the cases in which this supremacy is a part (reformer) of the refractory.
The refractoriness of existential supremacy is most difficult to establish by its dynamic evolution, by the medium of standardized and medium media it can also be presented in phases in the final stages of the process in which palliative sedation is not considered to be traditional. But the main problem is that existential supremacy is all about the medical and involving personal, cultural or religious aspects that are significantly important in life.
To plant palliative sedation in an existential supremacy, various conditions such as: appear in the context of an advanced terminal nurse, which can be considered refractory are evaluated in a repetitive manner by a multidisciplinary team, including those in the decision participates the families y / o the professional helpers.
In addition, in the case of existential supremacy, the first option must be the intermittent seduction in the case of continuous deep sedation. In any case, palliative care for existential supremacy should not be used to deliberately support a patient’s life.
In conclusion
Palliative medicine is the science of the level of supremacy intensely provoked by the grafted nurses. If the supremacy is to be onontbeerlike for the terminal patient, the adequate, the ethical, the medical … is aliviar with a medium proportion as the palliative sedation. Professionals need to be aware of palliative care, among those who correspond to the practice of palliative care. The governor and the legislature have an obligation to facilitate palliative care for all those who need it.