Carlos,
I'd also be fairly conservative, unless I had evidence that he was
salvageable to a reasonable life-style. Nonetheless, an independant
pedestrian at 96 has to be seen as an individual. I'd seek relatives or
friends to give me evidence, but would make my own decision.
The last time I did something like this was an elderly lady with Multiple
Sclerosis, who went into Status Epilepticus in the ED, with a Guedel airway
jammed in the upside down position blocking her airway. She had no IV
access, and was known to be wheelchair bound.
I performed a cric, aborted her fitting after gaining IV access by cutdown
and then discussed with her daughters and her previous Consultant physician
prior to being persuaded to refer her for ventilation to ICU. I got totally
castigated by the clever doctors from ICU , needless to say, but they took
her!!
12 months later I met her daughter as a patient, who was still pleased with
my aggressive approach and with the fact that her mother had recovered to
her pre-morbid state ie wheelchair bound and heavily dependant. The mother
was also pleased with the intervention!
There's nowt so strange as folk!!
Pat
-----Original Message-----
From: Carlos Arturo Perez Avila <[log in to unmask]>
To: INTERNET:[log in to unmask] <[log in to unmask]>
Date: 15 October 1998 19:36
Subject: RE: Trauma in the elderly
>Dear all: It was CO2 retention. The ICU Surgeons and myself had a meeting
>and balancing all available data we decided not to proceed with more
>agressive therapy. He passed away comfortably 2 hrs after admission. It is
>interesting to see that we can have aggresive colleagues as Pat Plunkett
>who will have giving him two chest drain and ventilation to the ones who
>would have not intubated and kept him comofrtable.
>
>I professor of mine with a great deal of humanity and common sense once
>told me. Patient have the right to die at some point in time and you always
>will need to balance quality of life and sufering before you inflict more
>pain in the interest of dogma or science. I think he was right then and
>right now. I certainly would not have like my father to go through
>Patrick's protocol.
>
>Carlos
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|