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January 2011, Volume 41 Number 1 , p 13 - 14


  • Joy Ufema MS, RN


At a palliative care conference, I heard you say that administering oxygen to an actively dying patient is life-prolonging. Under what circumstances would you withdraw this treatment?-J.Y., WASH.When a patient's in the final stages of illness and the goal is comfort care, oxygen should be given only to relieve respiratory distress. It isn't generally necessary for comfort; morphine and lorazepam do an excellent job keeping patients comfortable.I learned this from an intensivist who was terminally weaning a patient from a ventilator. He deliberately withheld a prescription for supplemental oxygen. He did, however, prescribe a morphine infusion "to be titrated for comfort." This gave the nurses plenty of leeway to use their judgment if the patient began laboring to breathe.I recall a 64-year-old patient with end-stage lung cancer. She was in coma and appeared peaceful while receiving 4 mg of morphine hourly. She was also receiving 50% oxygen via an oxygen mask. Her two daughters were camped

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