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 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

* 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)~~

|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.

* 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~~)

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 ==

* 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)

~~{{Stub}}~~

[[Category:Data Collection Guide]]

[[Category:Registry Data]]

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

}}

@@ Line 1: / Line 1: @@
-The '''DC Treat''' check box 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
-* 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)
+|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.
-* 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)
+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}}
-* 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)
-{{Stub}}
 [[Category:Data Collection Guide]]
+[[Category:Registry Data]]
+[[Category:End-of-life related data]]
+}}