Invasive ventilation is not appropriate and the patient is deteriorating. How would you manage them now?

Question

Accepted Answer

Given invasive ventilation is not appropriate and the patient is deteriorating, I would shift the focus to comfort and symptom control. For breathlessness I would prescribe low-dose opioids such as morphine; for agitation or anxiety, benzodiazepines such as midazolam; and for secretions, antimuscarinics such as glycopyrronium. I would stop non-comfort measures, involve palliative care early, and ensure the family are supported and informed throughout.

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