Palliative care in intensive care environments

A significant proportion of deaths in childhood, even those from life-limiting conditions, happen in an intensive care environment. An effective interface between palliative care services and the neonatal or paediatric intensive care unit is important but also presents certain specific challenges. This chapter looks at some of these challenges. It covers advance emergency care planning and compassionate extubation, examining the practicalities, symptom management, and parallel planning involved in this stage of care. Significant attention is also given to the ethics of compassionate extubation and symptoms during compassionate extubation.