The following is a summary of “Palliative Extubation: A Discussion of Practices and Considerations,” published in the April 2023 issue of Pain Management by Chen, et al.

Palliative extubation (PE), or compassionate extubation, is a common event in critical care settings and is crucial in end-of-life care. The primary goal of PE is to respect the patient’s preferences, improve comfort, and facilitate a natural death when other medical interventions, including continued ventilatory support, are no longer effective. However, PE can lead to unintended physical, emotional, psychosocial, or other stress for patients, families, and healthcare staff if not executed properly.

Studies have shown significant variability in the practice of PE worldwide, and evidence for best practices in this area is limited. Despite this, the COVID-19 pandemic has increased PE cases due to the higher number of critically ill patients requiring mechanical ventilation. Consequently, the effective conduct of PE has become even more crucial in current healthcare settings.

While some studies have provided guidelines for the PE process, this paper aims to present a comprehensive review of factors to consider before, during, and after a PE. The paper emphasized the core palliative care skills of effective communication, careful planning, thorough symptom assessment and management, and essential debriefing. The skills are vital in preparing healthcare workers to deliver quality palliative care during PE, especially during challenging situations like the COVID-19 pandemic.

By enhancing palliative care skills, healthcare professionals can better support patients and their families during PE, ensuring optimal end-of-life care and easing the emotional burden of this sensitive process. It was essential to utilize the knowledge to provide compassionate and effective care for PE patients and be prepared for future pandemics or similar situations.

Source: jpsmjournal.com/article/S0885-3924(23)00443-8/fulltext