PedsCrit Withdrawal of Life Sustaining Therapy with Jaime Jump
Mar 9, 2026
Jamie Jump, dual-trained pediatric critical care and palliative care physician and program director at Baylor/Texas Children’s, walks through withdrawal of life-sustaining therapy with clear, practical guidance. She covers preparing the room and family, anticipating symptoms, medication strategies, ventilator weaning, ethical distinctions, and team support. Multiple short, actionable topics are discussed with compassion and clinical detail.
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Use Symptom Control Intentionally And Document Ethics When Unsure
- Distinguish WOLST from euthanasia: medications are given with intent to relieve suffering, not to cause death (double effect principle).
- Use symptom-control meds appropriately and document ethics consult if teams feel moral distress.
Give Concrete Anticipatory Guidance About Physical Changes
- Prepare families with anticipatory guidance about physical changes: cover body to the neck, focus on the face, explain color, temperature, and noisy breathing.
- Stop feeds and fluids to reduce congestion and swelling; explain feeding isn't starvation but prevents harm.
Wean Ventilator Gradually And Use Glycopyrrolate For Secretions
- Use ventilator physiology to your advantage during weaning: reduce rate to allow CO2 rise (natural sedation) and chip away at PEEP rather than abrupt large drops.
- For secretions use glycopyrrolate and topical atropine; glycopyrrolate avoids central delirium effects.