Across London, paediatric trainees and trainers are focusing on Paediatric Palliative Care. Here are some ideas to think about.
Children who require palliative care can be cared for in various settings: in hospital, at home, or in a children’s hospice. Care also continues across other settings including education such as schools and universities and within community and leisure services, groups and clubs.
A Paediatric Palliative Medicine (PPM) specialist doctor has expertise working with children and young people with life-limiting illness, and their families. These conditions include malignancy, inherited disorders, neurological and neuromuscular disease and a variety of rare progressive and/or irreversible conditions. PPM doctors work alongside multi-disciplinary teams across hospital, hospice and community settings, providing a total approach to care focusing on quality of life; embracing physical, emotional, social and spiritual elements. PPM specialists provide specialist symptom management (e.g. nausea, pain, breathlessness, agitation), guidance with advance care planning (eg preferred place of care, ceilings of care), end of life and bereavement care and support with complex ethical decisions (e.g feeding/hydration).
PPM Paediatricians also have a vital role in supporting other healthcare professionals to care for children with life-limiting conditions.
- be familiar with national and local guidelines on withdrawing and withholding treatment
- be aware of legal and ethical issues relating to withdrawing life support
- know about appropriate therapeutic intervention in symptom control
- be aware of the ethical issues in therapeutic intervention in children with life-limiting conditions
- be familiar with guidelines on the management of sudden infant death
- know the tests for brain stem death
- know about guidelines on the management of sudden infant death, including the RCPCH Kennedy report
- know about the broad definition of palliative care in childhood
Courses and resources:
- Paediatric Palliative Care, Wednesday 28th June 2017
- Together for Short Lives: Uk Charity that provide support and resources for professionals and families. http://www.togetherforshortlives.org.uk/professionals/care_provision/care_pathways?gclid=COC3lrHDpNQCFRU8Gwod6REDSA
- The Association for Paediatric Palliative Medicine; http://www.appm.org.uk/
- RCPCH Paediatric Palliative Medicine: http://www.rcpch.ac.uk/training-examinations-professional-development/postgraduate-training/sub-specialty-training/paedi-10
- RCPCH Palliative care curriculum http://www.rcpch.ac.uk/sites/default/files/page/August%202016%20Paediatric%20Palliative%20Medicine%20Curriculum.pdf and Trainee Hand book: http://www.rcpch.ac.uk/system/files/protected/page/PPM%20trainees%20handbook.pdf