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Neurological




E
L
Autonomic dysregulation
Dystonias
Restlessness/agitation
Seizure
N
E
C
Pediatric Palliative Care
Restlessness/Agitation




Provide routine, comfort and
support
Decrease stimulation
Pharmacologic
Non-pharmacologic
 Relaxation
 Massage
E
L
N
E
C
Pediatric Palliative Care
Seizures
E

Frightening for parents to witness

May be caused by an electrolyte
imbalance, drug toxicity, meningitis,
or CNS tumor

Tonic/clonic or may present as
staring/eye deviation, lip smacking
or other repetitive movements
L
N
E
C
Pediatric Palliative Care
Dyspnea
E
L

Distressing shortness of breath

Breathlessness

Associated diseases
N
E
C
Pediatric Palliative Care
Causes of Dyspnea
E

Major pulmonary causes

Major cardiac causes

Major neuromuscular causes

Other causes
L
N
E
C
Pediatric Palliative Care
Assessment of Dyspnea

Use subjective report

Clinical assessment
 Physical
exam
 Diagnostic tests
E
L
N
E
C
Pediatric Palliative Care
Treatment of Dyspnea
E

Treating symptoms or
underlying cause

Pharmacologic treatments
L
N
E
C
Pediatric Palliative Care
Treatment of Dyspnea

Non-pharmacologic
 Oxygen
 Pursed
lip breathing
 Energy conservation
 Fans, elevation
 Counseling
 Other
E
L
N
E
C
Pediatric Palliative Care
Freedom
E
L
N
E
C
Pediatric Palliative Care
Terminal Respirations
E

Agonal or cheyne-stokes
breathing

Use an anti-cholinergic
medication for excess secretions

Provide family support
L
N
E
C
Pediatric Palliative Care
Fathers Watch
E
L
N
E
C
Pediatric Palliative Care
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