When to Stop: End-of-Life Care in the Austere Setting

Session Description: Little guidance exists regarding when to de-escalate aggressive treatments on critically ill patients, even in robust healthcare systems. In the limited resource setting, expenditure of medical supplies and effort have profound downstream effects when resupply is delayed or unreliable. Making the decision to discontinue attempts at resuscitation, particularly on teammates, challenges even the most experienced providers. This presentation will discuss the literature around end-of-life care and a framework for creating protocols for conservation of resources, palliative care, and how to discuss with teammates when refocusing efforts on management of pain and suffering when the patient will not survive.



Learning Objectives:

  • Upon completion, participant will be able to describe how logistical constraints in the austere combat setting limit resuscitative efforts.
  • Upon completion, participant will be able to describe prognostic factors to help guide when de-escalation of care would be appropriate.
  • Upon completion, participant will be able to develop palliative care protocols for use in austere combat settings.

Key:

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When to Stop: End-of-Life Care in the Austere Setting
Recorded 05/08/2025
Recorded 05/08/2025 Presenter: Jason Pickett, LTC – Battalion Surgeon, 2/19 Special Forces Group (Airborne) Session Description: Little guidance exists regarding when to de-escalate aggressive treatments on critically ill patients, even in robust healthcare systems. In the limited resource setting, expenditure of medical supplies and effort have profound downstream effects when resupply is delayed or unreliable. Making the decision to discontinue attempts at resuscitation, particularly on teammates, challenges even the most experienced providers. This presentation will discuss the literature around end-of-life care and a framework for creating protocols for conservation of resources, palliative care, and how to discuss with teammates when refocusing efforts on management of pain and suffering when the patient will not survive. Learning Objectives: Upon completion, participant will be able to describe how logistical constraints in the austere combat setting limit resuscitative efforts. Upon completion, participant will be able to describe prognostic factors to help guide when de-escalation of care would be appropriate. Upon completion, participant will be able to develop palliative care protocols for use in austere combat settings.
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