Sédation en situation d'urgence palliative : quelle responsabilité infirmière ?

Sedation in palliative emergency situation: what liability for the nurse? In palliative situations, acute complications leading to an immediate vital risk are an indication of practiced in emergency sedation. Such a sedation is often implemented when death seems imminent. In addition, terminal that emergency action may affect the timing of death. Therefore, this practice can lead to confusion with euthanasia. In this study, we focus on the liability of the nurse during the implementation of such early sedation protocol. The purpose of the study is to test the following hypothesis: “The clarification of euthanasia and sedation concepts facilitates the practice by the nurse of early sedation protocol in palliative emergency”. A questionnaire was given to 166 nurses working in various departments in Alsace likely to receive persons in end-of-life. Hundred and fifteen out of the 166 distributed questionnaires were returned, that is a response rate of 69%. Sixty-two nurses (54%) started an early sedation protocol in emergency situations, i.e. 27 and 35 with and without difficulty, respectively. The comparative analysis of the responses of these two groups of nurses brings some elements of verification of our hypothesis. A majority of elements promoting the clarification of concepts is found more in the group without difficulty. At the end of the study, it appears that the clarification of concepts is not sufficient by itself to facilitate the application of a sedation prescription by the nurse in an emergency situation.