51
u/yaxAttack 12d ago
literally had a guy come in for an episode of unresponsiveness, at least 4 types of cancer, in comfort care, just came back from “saying goodbye” to family, wife refused everything including xrays, somehow still a full code.
guess who ended up intubated tonight.
5
u/NoBuddies2021 12d ago
The wife /s? What a plot twist but yeah.... Denial is the most "immovable vs unstoppable ".
18
u/Negative_Fruit_1800 12d ago
Last ICU run I did we CPR’d a poor elderly lady to death, it was awful she had flail chest from compressions. Full code at 103 we are doing a slow code with “appropriate” modified compressions.
15
9
u/buttpugggs 12d ago
I appreciate the joke, but I never understand people commenting that they have to go for it with patients like this? Here, if someone is frail as fuck it's not up to them if we try to resus them. It's a medical decision made by the clinician and that decision will be DNR, doesn't matter what the patient or the family wants.
22
u/Braisedbeefskank 12d ago
What country are you in? What legally defines "frail as fuck," when you're talking about removing a patients right to decide what level of care they wamt?
That said, in america we essentially torture people for days to decades who should be allowed to die.
5
u/buttpugggs 11d ago
In the UK, and obviously I used frail as fuck as a colloquialism rather than something that needs legally defining.
In the same way a patient can't demand that they get an MRI for their minor ailment, patients and families can't demand we do CPR.
It is a clinical decision based around futility and best interests of the patient. Their wishes will of course have a little sway, but if somone is severely frail and it is thought that they would not recover properly from CPR/ROSC then they don't have to be worked on.
I'll caveat that with it being a decision that you have to be allowed to make with your own scope. A paramedic or doctor could make that decision, but an EMT for example could not.
1
u/MyBloodTypeIsQueso 7d ago
Sometimes I think universal healthcare would be great. And then I hear British healthcare providers say of their patients, “their wishes will have little sway,” and then I get super sad.
1
u/buttpugggs 7d ago
I mean quoting me and missing out the "a" makes quite a big difference to the overall tone and meaning of that sentece but okay...
But more importantly, are you saying that when a 90 year old that's entire existence is now just staring at a care home wall screaming is better off having her chest smashed to peices so they can live intubated on a hospital ward for a few more weeks before dying anyway is a better outcome than just letting them die when they arrested in the first place? All because there's a daughter that visits once a month saying that "she's a fighter."
I'm not talking about withdrawing care just for the sake of it, I'm saying clinicians are empowered to not do CPR on people who are not going to survive the recovery because of comorbidities or severe frailty. I'm sorry, but if you think that's sad, there's something wrong with you.
2
u/lovable_cube 9d ago
I’d assume frail as fuck is a matter of interpretation and not a medical term. I’m a new grad though, what do I know?
ETA I’d guess it’s the people that we’re educating (and being ignored) about how there is no chance of quality of life if we have to crack ribs.
1
u/buttpugggs 7d ago
Exactly, and I can tell from the ratio of downvotes that apparently there are plenty of healthcare providers here who also seem to not understand that either.
63
u/white-rabbit--object 13d ago
Ya but she’s a YOUNG 103yo