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Table 1 Guidelines for the use of sedation in patients near death in PCU Havelhoehe

From: Sedation in palliative care – a critical analysis of 7 years experience

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.