Answered By: Jeffrey Orrico Last Updated: Feb 01, 2017 Views: 1990
Some key phrases for your search include:
- left lateral ("LL", sometimes used in "left lateral decubitus" or "left lateral recumbent"), referring to a patient lying on his or her left side;
The MeSH (http://www.ncbi.nlm.nih.gov/mesh) thesaurus of Medical Subject Headings terms used in PubMed (and other academic and professional medical publications) can help you identify other search terms. Stop by the reference desk; a librarian can help you use this tool. Some of the MeSH terms that seemed relevant included:
- Terminal care
- Patient positioning
Searching in Google Scholar give access to a broad range of citations, although full-text access may require locating the relevant journal or book in the library or paying for access.
Several of the initial results returned made reference to LL positioning in response to the problem of venous gas embolisms which occured following the removal of a central venous catheter. Possibly, this could relate to the "tribal knowlege" you mentioned: if a CVC is removed from a patient in the final stages of an illness and receiving only palliative care, the prescribed left-lateral position may be coincident with death, though not necessarily causal. LL positioning is also used as a comfort and prophylactic measure for those in danger of aspiration of oral secretions (e.g., congestive heart failure), which is common among terminal illnesses.
Among the library's subscription databases, you can cross-database search several relevant EBSCO databases (Academic Search Premier; Cochrance Controlled Trials; Cochrance Systematic Reviews; Database of Abstracts of Reviews of Effects; and Medline). Other databases to consider include the Nursing and Allied Health databases from ProQuest, BMJ Best Practices, BMJ Clinical Evidence, Ovid, Science Direct, and Web of Science.
As you probably recall from your prior library research, to fully explore materials in these various sources, you will need to work methodically through the relevant terms in your searches, both formal subject headings and informal keywords and text occurrences. Keep of list of the terms and their synonyms you've tried, and add to the list terms that you see being used in potentially relevant materials.
Medical school libraries (such as Yale University (New Haven) and University of Connecticut (Farmington) may have additional searchable databases which you can use on site. Professional associations concerned with end of life care may have relevant discussions or studies reported on the "Deep Web" and less easily located via a broad "Google" search. A reference librarian can help you search for these online resources.
- In my father's case (end stage CHF) it definitely did. Which was a blessing at the time.
- I am sorry to hear of your father's difficult illness and your loss. I hope the medical information available through our library helps those affected to better understand an illness provide the best care for the patient.
- My father in law was in process of dying, lots of issues, including CHF. He had a hard time breathing this morning. And was put on full O2 mask. He kept trying to pull it off so when had to restrain his good arm, in fear of intubation. He was on morphine, and as the staff turned him, he died. So there might be something to this.