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. 2021 Apr 1;23(2):128-134.
doi: 10.1097/NJH.0000000000000728.

Field Notes From the Frontline of a COVID-19 Outbreak: Dyspnea Management for Hospitalized Patients at End-of-Life

Field Notes From the Frontline of a COVID-19 Outbreak: Dyspnea Management for Hospitalized Patients at End-of-Life

Dawn Pavlu et al. J Hosp Palliat Nurs. .

Abstract

Northern New Jersey was inside one of the worst initial coronavirus disease 2019 pandemic epicenters in the United States. At the peak of the pandemic surge in mid-April 2020, New Jersey saw 8045 hospitalized patients with severe coronavirus disease 2019 symptoms, of which 2002 were in intensive care unit beds (86.3% of statewide capacity), including 1705 requiring mechanical ventilation. Because of the severity of pulmonary dysfunction/hypoxia, the unprecedented numbers of critically ill patients, the national opioid shortage, and transmission prevention measures for standard palliative care treatment protocols in place for refractory and/or end-of-life dyspnea were found to be ineffective in providing adequate symptom relief. The aim of the following Notes From the Field is to provide concise, pragmatic, and experiential reflection by 3 palliative care advanced practice nurses from 3 different hospital systems within the pandemic epicenter. The novel methods and opioid strategies implemented by their respective palliative care teams to ensure continued effective and appropriate treatment for end-of-life dyspnea are described. These accounts include Lessons Learned in order to assist others who may need to quickly implement changes in the future due to pandemic resurgence or second-wave events.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

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