 |
 |
In article <[log in to unmask]>, Danny McGeehan <[log in to unmask]> writes >Hi all >Familiar scenario last Saturday night. Dept. like a madhouse and patient >arrives on the "999"'s c/o SOB. Vital signs and O2 saturation normal. >However has decreased air entry right side and CXR shows a complete >pneumothorax on the right side. >ABGs show normal CO2 but O2 decreased at just over 10 kpascals on room air. >Explained to patient that needs a intercostal drain as a probable potential >life saving procedure. He adamantly refuses to stay in hospital. Patient >counseled with wife and patiently explained that he could tension, develop >V/Q mismatch and in lay language severity of condition explained. >In spite of efforts of senior medical and nursing staff he signs his own >discharge and insists on leaving the department. Although at the lower end >of the standard distribution curve for IQ, he is not confused. >What would you do? I'd let him go, annoyed with my cowardice at not risking my career by detaining him unlawfully. Usual riders apply .... pt's GP called to inform them of the situation, full and contemporaneous notes to rely on when called upon to do so in coroner's court :( We give best advice ... but cant force patients to take it. Unless he is suffering from a mental illness under which he can be detained under the Mental Health Act 1983 ... one would find it difficult to justify treating him, without his consent, under common law. Now, when he returns, comatose .... the situation is different ....... Best wishes, -- Barry Salkin To reply to a news-post, delete the x from medxleg - its an antispam measure. Private e-mail shouldn't have the x present, unless I'm replying to a news-post of yours, in which case you'll still have to delete the x from the medxleg of the reply address.. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%