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Thu Mar 26, 2020, 04:35 AM

Hospitals consider universal do-not-resuscitate orders for coronavirus patients

https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/

Hospitals on the front lines of the pandemic are engaged in a heated private debate over a calculation few have encountered in their lifetimes — how to weigh the “save at all costs” approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of coronavirus.

The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment — such as masks, gowns and gloves — may be too great to justify the conventional response when a patient “codes,” and their heart or breathing stops.

Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.

Richard Wunderink, one of Northwestern’s intensive-care medical directors, said hospital administrators would have to ask Illinois Gov. J.B. Pritzker for help in clarifying state law and whether it permits the policy shift.

“It’s a major concern for everyone,” he said. “This is something about which we have had lots of communication with families, and I think they are very aware of the grave circumstances.”

Officials at George Washington University Hospital in the District say they have had similar conversations, but for now will continue to resuscitate covid-19 patients using modified procedures, such as putting plastic sheeting over the patient to create a barrier. The University of Washington Medical Center in Seattle, one of the country’s major hot spots for infections, is dealing with the problem by severely limiting the number of responders to a contagious patient in cardiac or respiratory arrest.


This is truly chilling that our medical personnel are even being put in the position to be forced to let someone die because they don't have the time to don (any available) PPE to rush in and save a Code Blue. Ordinarily the PPE would not be required - but here we are, living in "interesting times"...



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Arrow 27 replies Author Time Post
Reply Hospitals consider universal do-not-resuscitate orders for coronavirus patients (Original post)
Sunriser13 Thursday OP
Skittles Thursday #1
OhioChick Thursday #2
Sunriser13 Thursday #3
OhioChick Thursday #4
Sunriser13 Thursday #5
OldBaldy1701E Thursday #15
Sunriser13 Thursday #24
ashredux Thursday #6
Newest Reality Thursday #26
Sherman A1 Thursday #7
Chemisse Thursday #8
OhioChick Thursday #12
dewsgirl Thursday #21
Sunriser13 Thursday #16
malaise Thursday #9
ouija Thursday #11
OhioChick Thursday #13
malaise Thursday #14
Newest Reality Thursday #27
ck4829 Thursday #17
malaise Thursday #18
Chainfire Thursday #10
janterry Thursday #19
Duppers Thursday #20
lindysalsagal Thursday #22
Lars39 Thursday #23
Yo_Mama_Been_Loggin Thursday #25

Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 04:50 AM

1. let's see what the "pro-life" party says about this

oh yeah, Dan Patrick already told us

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 05:43 AM

2. I'm aware of what the contingency plans are

They're going to leave the population fucking shell-shocked.

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Response to OhioChick (Reply #2)

Thu Mar 26, 2020, 05:52 AM

3. That's the thing

You and other healthcare providers are always aware that there will be times when hard choices have to be made. It's an awful place to be; most entered the field to help people, not be forced to make these types of choices.

The "if only" chorus rings in my ears as my eyes leak hot, hot tears...

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Response to Sunriser13 (Reply #3)

Thu Mar 26, 2020, 05:58 AM

4. Doctors entered the profession to save lives, not to decide who lives or dies.

They took an Oath and do not want to carry this burden on their shoulders for the rest of their lives.....if they survive this.

Those that do survive are going to have PTSD for the rest of their lives.

Did you hear about the nurse in Italy that committed suicide? (RIP)
One can only deal with and "see" so much before cracking.

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Response to OhioChick (Reply #4)

Thu Mar 26, 2020, 06:04 AM

5. Oh, no! I hadn't seen that!

I'm afraid there will be more.

Mental health care is going to be a critical need for a very long time...

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Response to Sunriser13 (Reply #5)

Thu Mar 26, 2020, 07:25 AM

15. Which is hilarious...

We are already one of the worst when it comes to mental health, as most Americans don't want to believe it is real, and even if they do, they refuse to believe it is debilitating. (Unless you are wealthy, then you are taken seriously as long as the money holds out). The final joke in all this is that even if the general population does become more cognizant and compassionate about mental health, it will be too late for those of us who already suffer from this disease (yep, mental health issues are a disease, just like Covid). The fact that once again it took a major global catastrophe to finally create some awareness in people is even more disturbing. But, I have learned not to underestimate the human face when it comes to its denial of something it does't want to hear. Especially when there is no profit in it.

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Response to OldBaldy1701E (Reply #15)

Thu Mar 26, 2020, 10:07 AM

24. Isn't it, though?

I'm still trying to figure out the income level at which mental illness seems to become a 'badge of honor' and ceases to be something that affects just those lesser and dirty heathens; you know, the useless eaters.

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Response to OhioChick (Reply #2)

Thu Mar 26, 2020, 06:24 AM

6. "Shock Doctrine ".....read it. We are in it now

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Response to ashredux (Reply #6)

Thu Mar 26, 2020, 02:52 PM

26. Good call...

Yes, we are. The vultures will also be flying high over us all.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 06:53 AM

7. Very, Very Sad

But, not a surprise at all.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 07:06 AM

8. I am curious how often a person with a Covid-19 'code' is revived and goes on to survive.

Does it happen when they are that severely ill?

If not, this is a no-brainer. But if there is a reasonable chance they can still survive after resuscitation, then it is very sad.

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Response to Chemisse (Reply #8)

Thu Mar 26, 2020, 07:21 AM

12. I don't believe they bother with codes on COVID patients that are on vents

They're technically already gone from what I believe.

Lungs fill with fluid, followed by a massive heart attack.

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Response to OhioChick (Reply #12)

Thu Mar 26, 2020, 08:23 AM

21. I think you are likely correct.😭

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Response to Chemisse (Reply #8)

Thu Mar 26, 2020, 07:28 AM

16. There are other reasons to code

While Covid-19 is showing the cardiac symptoms, there are also trauma patients, cardiac patients without CV-19, and others who may also run into trouble.

This is heartbreaking on so many levels, but I can't help picturing providers rushing in anyway, because for some, if they didn't, they would never overcome the guilt. I cannot imagine being a provider on the sidelines, knowing the patient was being denied their last hope.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 07:08 AM

9. But don't you dare think about euthanasia for yourself

Words fail me

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Response to malaise (Reply #9)

Thu Mar 26, 2020, 07:13 AM

11. Isn't this

Supposed to be the greatest healthcare system in the world...seems not so.

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Response to ouija (Reply #11)

Thu Mar 26, 2020, 07:23 AM

13. Heathcare staff are great...

It's the lack of preparedness of our wonderful administration.

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Response to ouija (Reply #11)

Thu Mar 26, 2020, 07:23 AM

14. No it isn't

Any country that believes the market is more important than society is doomed to fail for all but a few.

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Response to ouija (Reply #11)

Thu Mar 26, 2020, 02:54 PM

27. That's an illusion.

For some, it very well may be.

For us? Well, the Easter Bunny is also the greatest bringer of eggs and chocolate.

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Response to malaise (Reply #9)

Thu Mar 26, 2020, 07:38 AM

17. A cognitive malfunction called omission bias for ya

Actively dying, assisted suicide are all horrible and immoral but letting someone die, not aiding them or preventing their death is... better... for some reason.

We're seeing a real life application of the trolley problem in our political landscape today.

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Response to ck4829 (Reply #17)

Thu Mar 26, 2020, 07:50 AM

18. I disagree re assisted suicide

If a rational person with a terminal illness wants to die, it is neither immoral nor horrible to me. My favorite cousin's wife chose euthanasia over terminal cancer.
That said I have a severe problem when the five persons on one track are all over 60 and the one person is young and they deliberately choose the track with the one person. That is horrible and immoral.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 07:12 AM

10. It is just a fact of life

Decisions will have to be made. C'est la guerre.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 07:54 AM

19. How many would survive even with intervention?



Of course it's terrible. If I'm in the hospital, I want everything possible done. But there's a reality that all medical professionals must face, in this situation. And as sad as this is - I recognize these facts. Until the curve substantially abates - hospitals must do what makes sense.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 08:14 AM

20. This reminds me of something I read about military triage

Physiological triage tools identify patients in categories:
(1) those needing immediate lifesaving interventions;
(2) those who need significant intervention that can be delayed;
(3) those who are so severely ill or injured that survival is unlikely despite major interventions.

Such hard, hard decisions.
My husband worked with burn surgeons in Maryland who were sometimes faced with such unbearable life and death decisions as described above. It's heartbreaking.


And speaking of keeping health care folks safe, they could use the equipment that these ChineseAir hostesses have...Wish we could order from them (& not be ripped off).
They can have these on airlines but the U.S. can't secure enough to save doctors' & nurses' lives here!!!!

?


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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 09:56 AM

22. Coding someone is horrific, violent, extremely traumatic

And exposes the entire patient. Plus, the contaminants from the patient are everywhere. It brings 6 or more people flying into a scene of panic and chaos, and into the space of one bed.

If your loved one has already suffered from enough to find themselves in a hospital bed, think twice, three times before subjecting him or her to the event.

It's a physical assault on a helpless victim. That's the reason it keeps the heart beating and lungs pumping.

All on a weakened patient who's going to have to recover in a compromised state. And it might just be putting off the inevitable, and need to be repeated.

It's not something you want to experience. It's not like on tv.

I can understand why this is being considered.

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 10:01 AM

23. With not enough testing, wouldn't everyone in a hospital then be

considered positive? And then there's the asymptomatic people...

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Response to Sunriser13 (Original post)

Thu Mar 26, 2020, 02:43 PM

25. Kick

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