RESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Técnicas de Apoio para a Decisão , Sistemas de Manutenção da Vida/instrumentação , Unidades de Terapia Intensiva , Estudos Prospectivos , Intervalos de Confiança , Estatísticas não ParamétricasRESUMO
Life-sustaining treatment limitation (LSTL) is an increasingly common practice. However, its application is sometimes not clearly reflected in the clinical record-this giving rise to the adoption of measures that could have been avoided, including admission to the intensive care unit (ICU), with the suffering and economical costs this implies. One way to trace patients subjected to LSTL is through an electronic registry allowing identification at all times of these individuals, and of the therapies that have been restricted in each case. The Ethics Committee of our center has developed a tool allowing the identification of patients subjected to LSTL and of the level of intervention required, and offering the association of a patient comfort management protocol.
Assuntos
Cuidados Críticos/ética , Registros Eletrônicos de Saúde , Registros Hospitalares , Cuidados para Prolongar a Vida , Futilidade Médica , Recusa em Tratar , Assistência Terminal , Cuidados Críticos/organização & administração , Humanos , Hipnóticos e Sedativos/uso terapêutico , Consentimento Livre e Esclarecido , Unidades de Terapia Intensiva/organização & administração , Cuidados para Prolongar a Vida/ética , Competência Mental , Entorpecentes/uso terapêutico , Cuidados Paliativos , Seleção de Pacientes , Recusa em Tratar/ética , Ordens quanto à Conduta (Ética Médica) , Espanha , Assistência Terminal/ética , Assistência Terminal/organização & administração , Recusa do Paciente ao Tratamento , Procedimentos DesnecessáriosRESUMO
A 30 year old woman with a history of depression and previous suicide attempts was brought to the emergency department in coma. She had injected herself with cyanide subcutaneously and had severe metabolic acidosis. She underwent sustained haemodialysis in the intensive care unit (ICU) before laboratory confirmation of cyanide poisoning. The serum cyanide concentration was 4.6 microg/ml. After 48 hours the patient, now asymptomatic, was discharged from the ICU.