18- "Last stage... "

Dying ...but no severe symptoms:

Do nothing or give normal symptomatic drugs.  Stop any unpleasant drugs ("31-TB") (see "29-Drug Resistance"...)

Dying with discomfort/pain:

A "last resort" if no morphine is available is a high dose of dexamethasone (4cc morning +2cc midday, or more) + tramadol without limitation (+diazepam if still has severe discomfort/pain or insomnia).  (See also "23-Pain")

For lungs discomfort:

·         DYSPNEA:    O2, dexamethasone

·         COUGHING AND SPUTUM

§         "Dry" secretions with Buscopan 1-2tabs 3-4x/day or IM or atropine if available...

§         Strong anti-tussive drugs: codeine syrup1-2 doses 3-4x/day

 

 

Don't forget that some "unconscious" patients can still hear...

...And pay attention to what you say around them.  Please, remember that kindness and care for unconscious patients are vital also!

If it is difficult for you to feel compassion:

Think of it as your mother or your best friend who is lying on the bed…

NB It is not always appropriate and sometimes cruel to be "a mother" for a dying patient or to touch him too much.  Be careful.  Point this out to Western volunteers who do not appreciate its significance.