Clinical review: the role of the intensivist and the rapid response team in nosocomial end-of-life care

  • A.K. H
  • D. J
  • R. B
 et al. 
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Abstract

In-hospital end-of-life care outside the ICU is a new and increasing aspect of practice for intensive care physicians in countries where rapid response teams have been introduced. As more of these patients die from withdrawal or withholding of artificial life support, determining whether a patient is dying or not has become as important to intensivists as the management of organ support therapy itself. Intensivists have now moved to making such decisions in hospital wards outside the boundaries of their usual closely monitored environment. This strategic change may cause concern to some intensivists; however, as custodians of the highest technology area in the hospital, intensivists are by necessity involved in such processes. Now, more than ever before, intensive care clinicians must consider the usefulness of key concepts surrounding nosocomial death and dying and the importance and value of making a formal diagnosis of dying in the wards. In this article, we assess the conceptual background, reference points, challenges and implications of these emerging aspects of intensive care medicine.

Author-supplied keywords

  • *Cross Infection/mo [Mortality]
  • *Cross Infection/th [Therapy]
  • *Hospital Rapid Response Team
  • *Intensive Care Units
  • *Terminal Care/mt [Methods]
  • *intensive care
  • *intensive care unit
  • *mortality
  • *procedures
  • *rapid response team
  • *terminal care
  • Advance Directives/td [Trends]
  • Cross Infection/di [Diagnosis]
  • Hospital Rapid Response Team/td [Trends]
  • Humans
  • Intensive Care Units/td [Trends]
  • Terminal Care/td [Trends]
  • cross infection/di [Diagnosis]
  • cross infection/th [Therapy]
  • death
  • dying
  • family
  • health care personnel
  • hospital admission
  • human
  • intensive care unit
  • intensivist
  • leadership
  • living will
  • nursing home
  • priority journal
  • review
  • terminal care
  • trends

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Authors

  • Hilton A.K.

  • Jones D.

  • Bellomo R.

  • Andrew K Hilton

  • Daryl Jones

  • Rinaldo Bellomo

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