Table 1.

Guidelines for the use of sedation in patients near death in PCU Havelhoehe

Indication:

Otherwise refractory and burdensome symptoms In terminal or final stages of the life of patients with Incurable disease – If death can be expected within the next 48 hrs

Decision-making:

Informed consent of patient, surrogates and palliative care team

Technique:

Continuous or Intermittent innfusion of sedatives (iv or sc e.g. midazolam 0,5 -mg/h +/- analgesics + co-medlcatlon). Lowest possible, adequate dosage to control symptoms under permanent observation and careful monitoring. Reduction of dosage In agony. Maintenance of all necessary medical and nursing support. Documentation.

Intention and ethics:

Reduction of distress, good sleep at night, adequate communication at daytime. Comfort and tolerance In the final phase – not to hasten death.