The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

Symptom Control in Patients with Terminal COPD

Debbie Lierl M.Ed., RRT Cincinnati State Technical and Community College, Cincinnati, Ohio

Palliative care of patients with end-stage COPD has not been widely advanced in medical journals and textbooks. The chronic nature of COPD often gives patients a false sense of longevity. Health care providers experienced at managing acute exacerbation are always hopeful that ventilatory failure, regardless of the frequency in the "well known to pulmonary services" patient, can be reversed.
When the functional level of the cardiopulmonary system is failing and patients and families come to terms with impending death, palliative care is the most reasonable choice. Principles of palliation are gradually being integrated into all levels of medical training. Palliative medicine focuses on compassionate care with a concerted effort to control the painful and debilitating presenting symptoms.
Patients with end-stage COPD are most likely to experience dyspnea, anxiety, pain, cough, anorexia/cachexia syndrome, confusion, and depression. Each individual symptom will be presented, along with suggested interventions for symptom relief.
Patients who choose palliative care must do so with full knowledge of the expected outcome, but they should be assured that all attempts would be made to keep them conscious and comfortable to the end.

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