CAPC Palliative Care Discussion Forum
General Operational Topics
Hi, There is a fast facts that may be helpful to you. You can find it at http://www.eperc.mcw.edu/fastFact/ff_92.htm.
If set correctly, PCA's are quite safe for patients... as they stop pressing the bolus button when they are sedated. For patients with significantly depressed mental status, one key is making sure family caregivers understand about the risk of over-sedation with bolus use... as they may be using pressing the button for the patient. If desired, an hourly maximum can be helpful, although simple education of family members is generally sufficient to have all working on the same goals of care.
At the end of life, in the hospital, in particular, frequent assessment of pain/distress/sedation is quite reasonable. In particular, non-invasive monitoring (observation, respiratory rate) is useful for adjusting palliative interventions and the frequent assessment is typically a source of comfort to the family.
Michael W. Rabow, MD
Associate Director,
UCSF Palliative Leadership Center
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Re:Patient Controlled Analgesia Pump Monitoring 
