Home extubation in a terminally ill older patient visiting emergency department

Abstract

This case report highlights the possibility of discharging terminally ill and intubated patients from the emergency department (ED) for home extubation. Many barriers exist in the ED that hinders home extubation for elderly palliative patients. Patients intubated in the ED are typically admitted to an intensive care unit or hospice. However, we present the case of a 93-year-old female patient brought to the ED due to altered consciousness, who experienced a sudden cardiac arrest, and subsequently received resuscitation and intubation. The patient's family expressed their desire to have her discharged for end-of-life care at home. By establishing effective communication and cooperation between a palliative care team, the ED staff, and the family members, a discharge care plan was developed to facilitate home extubation. The patient passed away peacefully within 40 hours of extubation, surrounded by her loved ones. This case exemplifies the feasibility of discharging terminally ill and intubated patients discharging from the ED for home extubation.