Palliative Care in the Intensive Care Unit

Are Residents Well Trained to Provide Optimal Care to Critically ill Patients?

1. Ghassan Kamel, MD1 Miguel Paniagua, MD2 Aditya Uppalapati, MD3⇑

1. ¹Department of Internal Medicine, St Louis University School of Medicine, St Louis, MO, USA
2. ²Division of General Internal Medicine, Section of Hospital Medicine, St Louis University School of Medicine, St Louis, MO, USA
3. ³Division of Pulmonary, Critical Care and Sleep Medicine, St Louis University School of Medicine, St Louis, MO, USA

1. Aditya Uppalapati, MD, Division of Pulmonary, Critical care and Sleep medicine, St Louis University School of Medicine, 7S-FDT, 1402S Grand Avenue, St Louis, MO 63104, USA. Email: auppalap@slu.edu

Abstract

Palliative care (PC) and end-of-life (EOL) care are gaining importance in the management of critically ill patients in the ICU. Residents form a significant work force in the ICU and most often are the only group that provides round the clock coverage.

Methods: We conducted a cross sectional study where residents were surveyed to assess their knowledge, skills and perceived barriers towards palliative care in the ICU.

Results: The most common barrier identified by our residents was discrepancies in goals of care between the medical team and patients/families (18.7%). A palliative care consult was most commonly obtained when the patient was terminally ill (22.9%).

Discussion: Teaching should focus on overcoming the identified barriers especially communication with patients and their families. More studies are needed to identify the best method to teach Palliative care in the ICU.