THREAD
1/ This is one of the most important #covid19 articles you will read
This is about advance care planning
About talking to your doctor- who you know/trust- before you're critically ill about what you want done if you are faced w/ the end of life
jamanetwork.com/journals/jama/…
1/ This is one of the most important #covid19 articles you will read
This is about advance care planning
About talking to your doctor- who you know/trust- before you're critically ill about what you want done if you are faced w/ the end of life
jamanetwork.com/journals/jama/…
2/ There has been so much discussion about ventilators, ICU bed capacity, ECMO, dialysis etc
We know that outcomes in the elderly w/ #covid19 in the ICU have been abysmal.
Many of these people will end up dying alone on ventilators, if they even get on one.
We know that outcomes in the elderly w/ #covid19 in the ICU have been abysmal.
Many of these people will end up dying alone on ventilators, if they even get on one.
3/ But is this really what all of these people would even want?
And is the time to discuss this when someone is critically ill in the hospital surrounded by people they've never met?
Primary care doctors NEED to be reaching out to their high risk patients, NOW
And is the time to discuss this when someone is critically ill in the hospital surrounded by people they've never met?
Primary care doctors NEED to be reaching out to their high risk patients, NOW
4/ This is a duty of a doctor-- to do right by our patients, we need to protect them from harm.
Leaving our patients to figure out their code status or end-of-life decisions in the middle of crisis is a form of harm, in my opinion.
It is avoidable. We need to address it.
Leaving our patients to figure out their code status or end-of-life decisions in the middle of crisis is a form of harm, in my opinion.
It is avoidable. We need to address it.
5/ @eshantang and I wrote about this but due to a number of issues, it has been delayed for almost a week now.
Will make sure to share it when it is out.
This might be one of the biggest things we as docs can do, right now.
If you're a high risk patient, call your doctor.
Will make sure to share it when it is out.
This might be one of the biggest things we as docs can do, right now.
If you're a high risk patient, call your doctor.
6/ Engage them in this conversation so that you can better understand what it means to be "full code"; what it means to be on a ventilator, or in an ICU.
These are important conversations.
And it is even more important that patients are having these BEFORE they are truly sick
These are important conversations.
And it is even more important that patients are having these BEFORE they are truly sick
7/ For those in the #palliativecare community-- we truly need leadership/guidance on the #covid19 front as it relates to #endoflife care.
The answer is not always "more ventilators" (although we do need these).
Sometimes, it is more conversations. More understanding of goals.
The answer is not always "more ventilators" (although we do need these).
Sometimes, it is more conversations. More understanding of goals.
cc @haiderwarraich @arielle_wilder many others in the palliative care community - not sure who else needs to see this (I'm sure most if not all have already been thinking/doing this-- but I've hardly seen advance care planning being talked/tweeted about)
See thread - please share if you’ve seen other efforts on advance care planning @choo_ek @EricTopol @eugenegu @FutureDocs @jflier @ashishkjha @IngridKatzMD @syramadad @Atul_Gawande @Bob_Wachter @thehowie @DhruvKhullar @neel_shah @danielalamasmd
