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KNMG Guideline for Palliative Sedation 2009 2

KNMG Guideline for Palliative Sedation 2009 2

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Published by Michael Cook

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Published by: Michael Cook on Jul 20, 2012
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02/06/2013

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KNMG Guideline for Palliative Sedation 2009 1
 
Guideline for Palliative Sedation
Royal Dutch Medical Association (KNMG)
Committee on National Guideline for Palliative SedationRoyal Dutch Medical Association (KNMG)Utrecht, The NetherlandsJanuari 2009
 
KNMG Guideline for Palliative Sedation 2009 2
 
© Royal Dutch Medical Association (KNMG)Postbus 200513502 LB UtrechtTel. 0031 (0)30 282 3322Fax 0031 (0)30 282 3326Emaile.van.wijlick@fed.knmg.nl 
For the online knowledge file on palliative sedation, see the website www.medischcontact.tv(Guideline in a downloadable form (also suitable for a PDA), e-learning, Web TV broadcast,articles and links)
 
 
KNMG Guideline for Palliative Sedation 2009 3
Contents
page
Summary
5
 1
 
Introduction
12
2
 
What is palliative sedation?
2.1 Relationship between palliative care and palliative sedation 172.2 Definition of palliative sedation 182.3 Structure of the guideline 202.4 Empirical data on the extent of the practice of palliative sedation 20
3
 
Indications and preconditions for palliative sedation
 3.1 Indications for palliative sedation 223.2 Preconditions for continuous sedation 253.3 An exceptional situation 26
4 The decision-making process
4.1 Timely and open communication 284.2 Reasons for considering palliative sedation 294.3 Determining whether indications for palliative sedation are present 294.4 Discussion with the patient and/or his representative 31
5 Administration of fluids
35
 6 Good medical practice
6.1 Preparations 38
 
6.2 The initiation of sedation 386.3 Proportionality 396.4 Drugs and method of administration 396.5 Morphine and continuous sedation until the moment of death 406.6 Supplementary measures 40
7 Record-keeping and evaluation
7.1 Record-keeping 427.2 Supervision and evaluation of the effects of palliative sedation 43
8 Brief or intermittent sedation
44
 9 Dealing with the patient’s family
46
 10 Caring for the carers
51
 11 Conclusions and quality of scientific evidence
54
 

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