Lect 5 - End of Life, trauma.docx - End of Life Trauma Chronic care End of Life Trauma leading cause of death 1-19 years CA leading cause of death by

End of Life, Trauma, Chronic care End of Life  Trauma leading cause of death 1-19 years  CA leading cause of death by disease  Causes of death – neonatal (<28 days old)  Causes of death – first year o SIDS still leading cause of death o Suffocation & drowning  trauma causes  Causes of death – age 1 – 4 o males more likely to have trauma & more likely to have more severe trauma (x2) o DROWNING o Burns, falls, poisoning - COMMON o Number one cause of death is head injuries o Diapered children = more abuse, increased risk if poor, young, single, abuse drugs/ETOH  Causes of death – age 5-9 o CA moved up

o Top age group for upper extremities fractures  Causes of death – age 10-14  o Suicides  think about pt’s mental health  Pt has more risky behaviors o Highest population of brain injuries & lower limb fractures  Due to car drives  Causes of death – age 15-19 o Homicide moved up significantly End of Life Care and Bereavement  Cultural beliefs, spiritual beliefs, and social support systems are central to a family’s response to death and loss.

 Not only have child but have siblings present. o What are the child’s thoughts and feelings and what are the siblings’?  Child’s developmental level determines how they think of death o Infants and toddlers  Don’t have mature understanding of death  Feed off of what parents are doing  Help parents cope; those kids cope better  Child reaction shadow’s parents’ reactions o Pre-school  Death temporary state – can come back  Blame themselves – siblings think its their fault  Patient can feel their body being sick & deteriorate  Bad dreams, spider on the wall, they know something is happening but they can’t always verbalize how they are feeling  Feel effects of medications & how they make them feel o School  By 7 – death is irreversible & do not come back  Still no mature understanding of death  Zombies, body parts fall off, don’t truly understand death  Fears of body integrity o Adolescents  Have mature understanding of death  Remember stage they are in in identity vs role confusion  They are trying to establish who they are – have hard time with crisis of identity & dying  Less likely to bring up issues with family  They know they are at end of life – less likely to start fights  Less likely to express themselves & plans for their future  Don’t want people to have bad memories of them... Culture  Each culture has its own way of defining, addressing, and acknowledging death  Baptism at bedside o Whatever religious leader they want to come in and perform religious rights o Some want bath before passing, some bathe after  Dispensation of body  Autopsy Suspect foul play – homicide, pt wil always have autopsy o Unless have defined reason for death – most will have autopsy  Donation  Keeping vigil o No candles at bedside – do have battery operated candles  Returning to a prior faith 