Journal article
Intracerebral Hemorrhage for the Palliative Care Provider: What You Need to Know
Journal of palliative medicine, v 11(10), pp 1336-1339
01 Dec 2008
PMID: 19115894
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Intracerebral hemorrhage (ICH) makes up 10%-30% of all strokes. Palliative care providers are often asked to get involved with ICH cases to aid with development of short-term and long-term goals. Prognosis can be calculated using the ICH score (based on Glasgow Coma Score score, ICH volume, presence of intraventricular hemorrhage, age, and location of origin) or the Essen score (based on age, NIH Stroke Scale [NIHSS], and level of consciousness). Do-not-resuscitate (DNR) status is important to discuss with families. Expert consensus states DNR is appropriate if the patient has two of the following: severe stroke, life-threatening brain damage, or significant comorbidities. The process of withdrawing ventilatory support can differ greatly from that of a medical intensive care unit (ICU) patient. Most ICH patients die within 24 hours following extubation. Symptoms of dyspnea and pain warrant use of opioids before and after terminal extubation. In addition, treating death rattle and postextubation stridor are important interventions. Family meetings are a vital intervention to help explain prognosis, establish a plan of care, and to get all family members on the same page. Family meetings can have a rapid effect, with 66% of families opting for withdrawal of life support to decide within 24 hours of such a meeting.
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Details
- Title
- Intracerebral Hemorrhage for the Palliative Care Provider: What You Need to Know
- Creators
- B. Brent Simmons - Temple UniversitySusan M. Parks - Thomas Jefferson University
- Publication Details
- Journal of palliative medicine, v 11(10), pp 1336-1339
- Publisher
- Mary Ann Liebert, Inc
- Number of pages
- 4
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Family (Community and Preventive) Medicine
- Web of Science ID
- WOS:000262085900014
- Scopus ID
- 2-s2.0-58149267980
- Other Identifier
- 991021961011304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services