An intervention to improve respiratory therapists' comfort with end-of-life care.

BACKGROUND: Respiratory therapists (RTs) are often involved in treating seriously ill and dying patients, but receive little instruction in end-of-life care. Prompted by several difficult cases, we developed an interdisciplinary program to introduce practicing RTs to ethical and end-of-life issues, and evaluated the program with a dedicated survey instrument. METHODS: A convenience sample of RTs from a university hospital and nearby community hospitals participated in a one-day interactive program, in 2005 (n = 49) and in 2008 (n = 36), that included role-play and didactic components. The questionnaire completed before and after the program included scales on comfort with end-of-life care and role in end-of-life care, and knowledge indices. RESULTS: Nearly all the RTs had recently encountered end-of-life situations, yet most had not received dedicated training and felt ill-prepared to deal with these situations; one third reported distress related to withdrawal of treatment. The 78 participants who completed both the before and after surveys had increased comfort with end-of-life care (P < .001) and their perception of their role in end-of-life care (P < .001). Knowledge about end-of-life care also increased (P < .001). CONCLUSIONS: A one-day interactive educational intervention can improve short-term RT comfort and role perception concerning end-of-life care. Evaluation of longer-term clinical outcomes and implementation in other venues is needed.

Mistura de hélio-oxigênio (heliox) em ostrução de vias aéreas / Helium-Oxigen (Heliox) mixture in airway obstruction

Objetivo: Demonstrar a eficácia e a rápida melhora dos pacientes tratatos com a mistura Hélio-oxigênio (Heliox). Essa mistura é utilizada em pacientes com obstrução das vias aéreas, de etiologias variadas, que não respondem ao tratamento convencional com oxigenioterapia. Métodos: Apresentamos quatro pacientes com obstrução das vias aéreas. Esses pacientes receberam como terapêutica o Heliox e apresentaram resultados satisfatórios e praticamente livres de efeitos colaterias no curso do tratamento. Resultado: Os pacientes que receberam a mistura de hélio-oxigênio (Heliox) apresentaram um resultado satisfatório e mais rápido que os pacientes tratados com mistura convencional. Conclusão: O Heliox apresenta-se como terapêutica promissora no tratamento de obstrução graves das vias aéreas, com resposta rápida por parte do paciente, até que tratamento final seja estipulado como terapêutica definitiva