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Resuscitate but not Intubate? Partial Codes in Pediatrics.
Silverman, Andrew; Batten, Jason; Berkman, Emily; Fitzgerald, Heather; Epstein, Beth; Shearer, Emily; Diekema, Douglas; Burgart, Alyssa.
Afiliación
  • Silverman A; Division of Child Neurology, Department of Neurology.
  • Batten J; Department of Anesthesiology, Perioperative, and Pain Medicine, and.
  • Berkman E; Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Palo Alto, California.
  • Fitzgerald H; Divisions of Pediatric Critical Care Medicine.
  • Epstein B; Bioethics and Palliative Care.
  • Shearer E; Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Palo Alto, California.
  • Diekema D; University of Virginia School of Nursing, Charlottesville, Virginia.
  • Burgart A; Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island.
Pediatrics ; 152(2)2023 08 01.
Article en En | MEDLINE | ID: mdl-37435669
The use of partial code status in pediatric medicine presents clinicians with unique ethical challenges. The clinical vignette describes the presentation of a pulseless infant with a limited life expectancy. The infant's parents instruct the emergency medicine providers to resuscitate but not to intubate. In an emergency, without a clear understanding of parents' goals, complying with their request risks an ineffective resuscitation. The first commentary focuses on parental grief and how, in certain circumstances, a partial code best serves their needs. Its authors argue that providers are sometimes obligated to endure moral distress. The second commentary focuses on the healthcare team's moral distress and highlights the implications of a relational ethics framework for the case. The commentators emphasize the importance of honest communication and pain management. The final commentary explores the systems-level and how the design of hospital code status orders may contribute to requests for partial codes. They argue systems should discourage partial codes and prohibit resuscitation without intubation.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Pediatría / Intubación Tipo de estudio: Prognostic_studies Idioma: En Revista: Pediatrics Año: 2023 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Pediatría / Intubación Tipo de estudio: Prognostic_studies Idioma: En Revista: Pediatrics Año: 2023 Tipo del documento: Article