Article Text

other Versions

PDF
Predicting death in children
  1. Lynda Ann Brook (lynda.brook{at}rlc.nhs.uk)
  1. Royal Liverpool Children's Hospital, United Kingdom
    1. Richard DW Hain (hainrd{at}cardiff.ac.uk)
    1. Cardiff University School of Medicine, United Kingdom

      Abstract

      It is rare for paediatric palliative medicine physicians to have to break news of a diagnosis of a life-limiting condition (LLC). Usually that has been done weeks or months before. It is much commoner for us to be faced with the question: "how long?" Clearly it is a question that cannot be answered with certainty, and yet a great deal may depend on it. While palliative care (PC) should ideally be available from diagnosis, the need for 'active' practical PC intervention will fluctuate during the course of a child's illness. For most children this will last months or years; often decades. Typically, there will be several periods during which death seems likely before the final terminal episode, particularly among children with non-malignant LLC. Optimal management of all these episodes depends on anticipating the child’s needs in order for timely interventions - or withdrawal of interventions - to be considered. This consideration in turn depends on recognising that such an episode has begun. Providing adequate PC critically depends on making a diagnosis of dying. In this article, we will consider why it is important to make a 'diagnosis of dying', briefly review some of the tools available to help, and examine some of the evidence from published literature in children and adults.

      Statistics from Altmetric.com

      Request permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.