when patients come in unconscious they do not have a say in their medical care|Course hero helper
Posted: February 11th, 2023
Patient Decision
I work in the emergency room, and we have a variety of times when patients come in unconscious they do not have a say in their medical care. One example when a patient had a voice in their care is with a patient who had gone septic. This patient was accompanied by their daughter, and the patient’s blood pressure was rapidly dropping. We had this patient in the ER as an ICU hold because the ICU was full. The ICU doctor came to the bedside in the trauma room and discussed intubation with the patient and his family. The daughter and the patient were really against the idea of intubation. The patient was put under pressers, but the blood pressure was rapidly declining, and the patient started not to be able to compensate. Eventually, the patient had to be emergently intubated, and we had to call the house supervisor to get the patient to the ICU as fast as possible.
Consequences
They were considering the patient’s wishes and desires in this situation may have negatively impacted the patient’s outcomes. The patient was transferred to the ICU post-intubation, so I do not know what the result was. Had the patient been intubated earlier, they may have had a more positive outcome or extubated sooner than they were. It is impossible to know precisely what would have been different had he been intubated sooner than he was. It is vital to give the patient the right to make their own decisions, but it is the medical staff’s job to ensure the patient has all the needed information to make a decision (Olejarczyk & Young, 2022).
Aide
I would use the decision aid for this individual, specifically for the daughter. Since the patient is intubated in the ICU, there are a variety of decisions and questions that the family members will most likely have. The aide is titled “Understanding the Options: Planning Care for Critically Ill Patients in the intensive care Unit. This aide addresses treatment options in the ICU and discusses the need for family members to make decisions (Kryworuchko, 2015). In general, this aid is helpful because when a patient is in the ICU, it is complex for a family member to know their role (Alsharari, 2019). The family has much more say in the healthcare of an intubated patient due to the patient’s inability to make decisions (Kryworuchko, 2015).
Using this Model in Everyday Life
I will use this model in my work in the ER. We have many patients that end up getting intubated and go up to the ICU. It would be necessary to educate the patient and their family members about what is entailed in intubation and the ICU. Family members play a vital role in the treatment of an intubated patient, and this aide can educate the family on what that role is (Alsharari, 2019).
Resources
Alsharari A. F. (2019). The needs of family members of patients admitted to the intensive care unit. Patient preference and adherence, 13, 465–473. https://doi.org/10.2147/PPA.S197769
Kryworuchko, J. (2015). Ottawa Hospital Research Institute. Understanding the Options: Planning Care for Critically Ill Patients in intensive care Unit. Retrieved January 31, 2023, from https://decisionaid.ohri.ca/Azsumm.php?ID=1388
Olejarczyk, J. P., & Young, M. (2022, November 28). Patients’ Rights and Ethics. National Library of Medicine. Retrieved January 31, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK538279/
SOLUTION
of not intubating a patient in such a scenario can be severe and potentially life-threatening. Septic shock is a medical emergency that can cause a rapid decline in a patient’s vital signs and lead to organ failure if not treated promptly and appropriately. In this case, the patient’s declining blood pressure and inability to compensate indicated that the patient was in a dangerous condition and required immediate intervention.
Intubation is a procedure that involves inserting a tube into the patient’s airway to help maintain their breathing. In this case, intubation was necessary to provide life support and stabilize the patient’s condition. Although the patient and their family were initially against the idea of intubation, the healthcare provider had a duty to act in the best interest of the patient and provide appropriate medical care in the emergency situation.
It’s important to remember that in emergency situations, medical decisions may have to be made quickly and with limited information, and the patient may not always be able to provide consent or have a say in their care. However, healthcare providers should always strive to involve the patient and their family in decision-making to the extent possible and keep them informed of the situation and treatment options.
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