DC Treatment: Difference between revisions

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The ~~'''DC Treat''' checkbox on the Registry page of the PDA tracks the withdrawal of treatment in dying ICU 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

| todo_action = 2023-05-04

| question = _dev_CFE_Data

* The field has a length of 50 and should be reduced to 2 now that that's the longest content.

}}

== ~~When not~~ to ~~code "DC Treat"~~ ==

{{LegacyContent

* "DC Treat" is not coded on Medicine wards

|explanation=stopped collection in Medicine

|successor= various tmp and dx codes relating to [[palliative patient]]s and [[:category:End-of-life related data|End-of-life related data]]

|content=

{{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

}}

~~== Additional info needed to de~~-~~stub ==~~

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.

* ~~This article came about because of article~~ [[~~Palliative care vs DC TX~~]]~~; when this and the~~ [[~~Palliative Care~~]] ~~article are cleaned up, then~~ [[~~Palliative care vs DC TX~~]] ~~should be~~ removed.

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 ==

~~{{Stub}}~~

[[Category:Data Collection Guide]]

[[Category:Registry Data]]

[[Category:End-of-life related data]]

}}

@@ Line 1: / Line 1: @@
-The '''DC Treat''' checkbox on the Registry page of the PDA tracks the withdrawal of treatment in dying ICU 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
+ | todo_action = 2023-05-04
+ | question = _dev_CFE_Data
+* The field has a length of 50 and should be reduced to 2 now that that's the longest content.
+}}
-== When not to code "DC Treat" ==
+{{LegacyContent
-* "DC Treat" is not coded on Medicine wards
+|explanation=stopped collection in Medicine
+|successor= various tmp and dx codes relating to [[palliative patient]]s and [[:category:End-of-life related data|End-of-life related data]]
+|content=
+{{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
+}}
-== Additional info needed to de-stub ==
+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.
-* This article came about because of article [[Palliative care vs DC TX]]; when this and the [[Palliative Care]] article are cleaned up, then [[Palliative care vs DC TX]] should be removed.
+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}}
-{{Stub}}
 [[Category:Data Collection Guide]]
+[[Category:Registry Data]]
+[[Category:End-of-life related data]]
+}}