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Sunriser13

(612 posts)
Thu Mar 26, 2020, 04:35 AM Mar 2020

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"...



27 replies = new reply since forum marked as read
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Hospitals consider universal do-not-resuscitate orders for coronavirus patients (Original Post) Sunriser13 Mar 2020 OP
let's see what the "pro-life" party says about this Skittles Mar 2020 #1
I'm aware of what the contingency plans are OhioChick Mar 2020 #2
That's the thing Sunriser13 Mar 2020 #3
Doctors entered the profession to save lives, not to decide who lives or dies. OhioChick Mar 2020 #4
Oh, no! I hadn't seen that! Sunriser13 Mar 2020 #5
Which is hilarious... OldBaldy1701E Mar 2020 #15
Isn't it, though? Sunriser13 Mar 2020 #24
"Shock Doctrine ".....read it. We are in it now ashredux Mar 2020 #6
Good call... Newest Reality Mar 2020 #26
Very, Very Sad Sherman A1 Mar 2020 #7
I am curious how often a person with a Covid-19 'code' is revived and goes on to survive. Chemisse Mar 2020 #8
I don't believe they bother with codes on COVID patients that are on vents OhioChick Mar 2020 #12
I think you are likely correct.😭 dewsgirl Mar 2020 #21
There are other reasons to code Sunriser13 Mar 2020 #16
But don't you dare think about euthanasia for yourself malaise Mar 2020 #9
Isn't this ouija Mar 2020 #11
Heathcare staff are great... OhioChick Mar 2020 #13
No it isn't malaise Mar 2020 #14
That's an illusion. Newest Reality Mar 2020 #27
A cognitive malfunction called omission bias for ya ck4829 Mar 2020 #17
I disagree re assisted suicide malaise Mar 2020 #18
It is just a fact of life Chainfire Mar 2020 #10
How many would survive even with intervention? janterry Mar 2020 #19
This reminds me of something I read about military triage Duppers Mar 2020 #20
Coding someone is horrific, violent, extremely traumatic lindysalsagal Mar 2020 #22
With not enough testing, wouldn't everyone in a hospital then be Lars39 Mar 2020 #23
Kick Yo_Mama_Been_Loggin Mar 2020 #25

OhioChick

(23,218 posts)
2. I'm aware of what the contingency plans are
Thu Mar 26, 2020, 05:43 AM
Mar 2020

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

Sunriser13

(612 posts)
3. That's the thing
Thu Mar 26, 2020, 05:52 AM
Mar 2020

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...

OhioChick

(23,218 posts)
4. Doctors entered the profession to save lives, not to decide who lives or dies.
Thu Mar 26, 2020, 05:58 AM
Mar 2020

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.

Sunriser13

(612 posts)
5. Oh, no! I hadn't seen that!
Thu Mar 26, 2020, 06:04 AM
Mar 2020

I'm afraid there will be more.

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

OldBaldy1701E

(4,968 posts)
15. Which is hilarious...
Thu Mar 26, 2020, 07:25 AM
Mar 2020

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.

Sunriser13

(612 posts)
24. Isn't it, though?
Thu Mar 26, 2020, 10:07 AM
Mar 2020

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.

Chemisse

(30,793 posts)
8. I am curious how often a person with a Covid-19 'code' is revived and goes on to survive.
Thu Mar 26, 2020, 07:06 AM
Mar 2020

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.

OhioChick

(23,218 posts)
12. I don't believe they bother with codes on COVID patients that are on vents
Thu Mar 26, 2020, 07:21 AM
Mar 2020

They're technically already gone from what I believe.

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

Sunriser13

(612 posts)
16. There are other reasons to code
Thu Mar 26, 2020, 07:28 AM
Mar 2020

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.

malaise

(267,827 posts)
14. No it isn't
Thu Mar 26, 2020, 07:23 AM
Mar 2020

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

Newest Reality

(12,712 posts)
27. That's an illusion.
Thu Mar 26, 2020, 02:54 PM
Mar 2020

For some, it very well may be.

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

ck4829

(34,977 posts)
17. A cognitive malfunction called omission bias for ya
Thu Mar 26, 2020, 07:38 AM
Mar 2020

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.

malaise

(267,827 posts)
18. I disagree re assisted suicide
Thu Mar 26, 2020, 07:50 AM
Mar 2020

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.

 

janterry

(4,429 posts)
19. How many would survive even with intervention?
Thu Mar 26, 2020, 07:54 AM
Mar 2020


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.

Duppers

(28,094 posts)
20. This reminds me of something I read about military triage
Thu Mar 26, 2020, 08:14 AM
Mar 2020

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!!!!

?


lindysalsagal

(20,444 posts)
22. Coding someone is horrific, violent, extremely traumatic
Thu Mar 26, 2020, 09:56 AM
Mar 2020

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.

Lars39

(26,093 posts)
23. With not enough testing, wouldn't everyone in a hospital then be
Thu Mar 26, 2020, 10:01 AM
Mar 2020

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

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