P0452 / #926: CARE OF THE DYING CHILDREN AND THEIR FAMILIES IN BRAZILIAN PICUS: ARE WE DOING WHAT WE CAN?

Abstract

Aims & Objectives: Care of the dying child involves alleviating suffering, compassion and memory building. We aimed to survey Brazilian PICU teams about the current End of Life (EoL) approaches, examining if common procedures performed elsewhere are feasible or applied in their country. Methods: A survey tested beforehand, containing Likert style answers and few open questions, was sent via email to professionals in 3 PICUs in Brazil’s center-south hospitals (A.Private, B.Public and a C.University Oncology) as a pilot study. Institutional ethics committees, Gov. research registry, and individual consent were obtained. During the 3 months (09-11/2019), 3 reminders were sent. Few open questions were applied, and a thematic analysis was taken. Results: Overall, 136 surveys returned (response rate: 23% total; Physicians: A.31%, B.25% and C.60%), Overall 35% Physicians, 31% Nurses, 20% Nurses technicians and 14% Physiotherapists responded. The majority (80%) felt that having parents present or holding the child while treatment withdrawal is performed is feasible, even though only 15% have witnessed terminal extubation. Over 85% feel comfortable medicating for comfort at EoL, with opioids and benzodiapenics (98%), but 8% added a paralytic drug in the combo. After the child’s death, 47% agree/somewhat agree that meeting the family is important; 52% agree/somewhat agree that sending a condolence’s letter is important, but only 13% had done it; 15% have organized memorial celebrations for the children. Conclusions: Many common practices at EoL are accepted but not performed consistently in the Brazilian PICUs. Further studies are needed to ascertain the reasons behind these findings and perhaps education may be necessary.