DC Treatment: Difference between revisions

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The '''DC Treat''' check box on the Registry page of the PDA tracks the withdrawal of treatment in dying patients when appropriate.
The concept encoded by this is slightly different than other [[:Category:End-of-life related data|End-of-life related data]] so it can not be transferred into new fields that encode related concepts, so we will keep it in the [[Centralized_data.accdb]]'s [[L Log table]]. It has been removed from [[CCMDB.accdb]].
Withdrawal of treatment is not the same as withdrawal of care.  DC Treatment in an ICU setting occurs because it is often possible to maintain life for long periods of time without any hope of recovery.  Intensive care is a means of supporting organ systems and it is not always curative.  Prolonging the process of dying is not in the patient's best interests nor is it ethical. (Winter,B. & Cohen,S. (1999).  ABC of intensive care. Withdrawal of treatment. ''BMJ 319'', 306-308.)


== When to code "DC Treat" ==
{{Todo
* when the decision is made to discontinue treatment in ICU
| who = Tina
* even if [[Palliative Care]] (90400) is provided and coded
| todo_added = 2022-06-30
As per the manual:
| todo_action = 2023-05-04
March 12.03 UPDATES
| question = _dev_CFE_Data
RE: DC TREATMENT & TRANSFER/DISCHARGE READY DATES:
* The field has a length of 50 and should be reduced to 2 now that that's the longest content.  
If you ICU physician DC’s TX (withdraws therapy) on a patient then TRANSFER/DISCHARGE READY DATE is NOT NEEDED.
}}


If a patient is on the transfer ready list and his condition deteriorates
{{LegacyContent
resulting in the need to remain in the unit, then this patients transfer ready is CANCELLED.  Please delete transfer ready date and time from your patient
|explanation=stopped collection in Medicine
Registry date or remember to change it if a patient is put back on the
|successor= various tmp and dx codes relating to [[palliative patient]]s and [[:category:End-of-life related data|End-of-life related data]]
transfer/discharge ready list.
|content=


If a patient arrests in your unit and CPR is unsuccessful—the date and time of stopping CPR should not be recorded for TRANSFER/DISCHARGE ready.
{{Data_element
| field_name = R_dc_treat
| element_description = "DC" for critical care patients if life-support treatment is terminated, blank for all others.  
| in_table = L_Log table
| data_type = string
| datafield_length=50
| program_collecting = CC
| created_raw = Raw
| data_element_sort_index = 12
| data_element_end_date = 2022-05-10
}}


If an unit physician discontinues TX and a patient is put on the transfer/discharge ready list but unexpectedly passes away prior to being to being moved out of your unit, then the recording of TRANSFER/DISCHARGE READY is appropriate.
This field was also collected in Medicine until 2013-07-04. Collection stopped because the distinction is not clear enough for coding on a medicine ward.


== When not to code "DC Treat" ==
Defined as terminal withdrawal with expectation of death of:
* "DC Treat" is not coded on Medicine wards
* invasive mechanical ventilation (ET tube or trach)
* This is not true at HSC. We are using the DC treatment code on the Medicine wards. [[User:GHall|GHall]] 19:14, 8 May 2008 (CDT)
* vasopressors or inotropes
* [[ECMO, VV]], [[ECMO, VA]]
* VAD (Ventricular assistive device)  


{{discussion}}
== See Also ==
== Discussion ==
See: [[Comfort Care]]  
* Is there an expectation to see DC patients survive their ICU stay? How sure of an expectation? Can this still be checked if the patient survives?  Usually DC treatment involves removing life support devices which subsequently results in death.  However, occasionally the patient may survive to go to a Palliative care ward and in this event [[Palliative care]] should also be coded.  --[[User:LKolesar|LKolesar]] 12:54, 8 May 2008 (CDT)
 
== Log ==
* 2022-05-10 removed from collection screen
 
== Related articles ==
{{Related Articles}}


* Our current practice on Medicine at HSC is to use the DC treatment code when treatment is stopped and death is expected imminently.We have recently talked to Trish about how to code our comfort care patients and using the DC treatment box is often the case. If the patients death is not expected imminently we use the code for palliative care.It is confusing because the term palliative can mean many things. [[User:GHall|GHall]] 19:11, 8 May 2008 (CDT) 


* I removed the "ICU" from the instructions above. The first line used to say "in dying '''ICU''' patients. According to chats with Julie and I think Gail, it's not just ICU patients. [[User:Ttenbergen|Ttenbergen]] 23:30, 26 May 2008 (CDT)
{{Stub}}
[[Category:Data Collection Guide]]
[[Category:Data Collection Guide]]
[[Category:Registry Data]]
[[Category:End-of-life related data]]
}}

Latest revision as of 11:32, 30 July 2025

The concept encoded by this is slightly different than other End-of-life related data so it can not be transferred into new fields that encode related concepts, so we will keep it in the Centralized_data.accdb's L Log table. It has been removed from CCMDB.accdb.

_dev_CFE_Data

  • The field has a length of 50 and should be reduced to 2 now that that's the longest content.
  • added: 2022-06-30
  • action: 2023-05-04
  • Cargo


  • Categories

Legacy Content

This page contains Legacy Content.

Click Expand to show legacy content.

 
 
 
 

Legacy Content

This page contains Legacy Content.

  • Explanation: This is a legacy data field, its DataElementEndDate is in the past.
  • Successor: No successor was entered

Click Expand to show legacy content.

Data Element (edit)
Field Name: R_dc_treat
CCMDB Label: not stated
CCMDB tab: not stated
Table: L_Log table
Data type: string
Length: 50
Program: CC
Created/Raw: Raw
Start Date: 1988-07-11
End Date: 2022-05-10
Sort Index: 12
Data Dependencies(Reports/Indicators/Data Elements): No results

"DC" for critical care patients if life-support treatment is terminated, blank for all others.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


This field was also collected in Medicine until 2013-07-04. Collection stopped because the distinction is not clear enough for coding on a medicine ward.

Defined as terminal withdrawal with expectation of death of:

  • invasive mechanical ventilation (ET tube or trach)
  • vasopressors or inotropes
  • ECMO, VV, ECMO, VA
  • VAD (Ventricular assistive device)

See Also

See: Comfort Care

Log

  • 2022-05-10 removed from collection screen

Related articles

Related articles:
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