Wong Kevin, Camacho James H S, Dulani Saakshi, Trivedi Kovid
Internal Medicine, Western University of Health Sciences, Lebanon, USA.
Pulmonary/Critical Care Medicine, Salem Pulmonary Associates/Salem Health, Salem, USA.
Cureus. 2022 Oct 14;14(10):e30313. doi: 10.7759/cureus.30313. eCollection 2022 Oct.
The Hippocratic Oath establishes the principle of or "first do no harm" in Western medicine. This not only includes physical health but also encompasses emotional and spiritual health. Various end-of-life care (EOLC) practices exist in different societies, and it is hard but vital for the healthcare community to be aware of these practices to allow wholesome care for their patients, which is emotionally and spiritually fulfilling. A 57-year-old male with a history of metastatic squamous cell carcinoma of the head and neck region presented to the emergency department after an out-of-hospital cardiac arrest. After appropriate post-cardiac arrest care, the patient remained unresponsive, and the family decided to transition to comfort-focused care. Based on their religious and cultural preferences, they preferred palliative extubation at a place where the patient would not have a roof over his head at the time of death, as well as sought help to facilitate a same-day funeral. After coordinating with various departments in the hospital, the patient was taken to the hospital helipad and extubated there in the family's presence. The patient's remains were released to the family within an hour of death for a timely funeral. This case is an example of cultural and religious diversity that exists within our community. Healthcare is a complex field and EOLC is a crucial part of patient care. With a multi-disciplinary approach towards EOLC, the distress related to death can be reduced among families as well as healthcare teams.
希波克拉底誓言确立了西方医学中“不伤害”或“首先不造成伤害”的原则。这不仅包括身体健康，还涵盖情感和精神健康。不同社会存在着各种临终关怀（EOLC）实践，对于医疗保健界来说，了解这些实践虽然困难但至关重要，以便为患者提供全面的护理，这种护理在情感和精神上都是令人满足的。一名57岁男性，有头颈部转移性鳞状细胞癌病史，在院外心脏骤停后被送往急诊科。经过适当的心脏骤停后护理，患者仍无反应，家属决定转为以舒适为重点的护理。根据他们的宗教和文化偏好，他们希望在患者死亡时没有屋顶遮蔽的地方进行姑息性拔管，并寻求帮助以便在同一天举行葬礼。在与医院各部门协调后，患者被送往医院直升机停机坪，在家人面前进行了拔管。患者遗体在死亡后一小时内交给家属，以便及时举行葬礼。 这个案例是我们社区中存在的文化和宗教多样性的一个例子。医疗保健是一个复杂的领域，临终关怀是患者护理的关键部分。通过对临终关怀采取多学科方法，可以减少家庭以及医疗团队与死亡相关的痛苦。
