Managing Use of Propofol for Refractory Symptoms in End-of-Life Care: Creating an Institutional Guideline.

Abstract

End of life (EOL) care in hospitals is increasingly complex as patients are often critically ill and medically unstable. Propofol can be an important tool in treating refractory symptoms during EOL care to ensure comfort and prevent suffering during the dying process. We aimed to define and standardize institutional practices for using propofol to manage refractory symptoms during EOL care. Using expert opinions, consensus building, and a microsystems team approach, we defined parameters for propofol use in managing refractory symptoms. We developed a flow diagram to guide decision making for propofol use during EOL care. We developed a flow diagram as a decision-making tool that reduced confusion and hesitancy about the appropriate use of propofol for refractory symptoms during EOL care. Using a multidisciplinary process, we standardized an institutional approach for use of propofol in managing refractory symptoms during EOL care in hospital.