THREAD.
Recent days have seen a lot of conversations about how #COVID19 is impacting upon decisions around end of life care, particularly for those of us with bodies that are more broken than most.
The majority of tweets are angry & many are verging on despair. (1/9)
Recent days have seen a lot of conversations about how #COVID19 is impacting upon decisions around end of life care, particularly for those of us with bodies that are more broken than most.
The majority of tweets are angry & many are verging on despair. (1/9)
The fact that such fear and misinformation exists within the disabled community is perhaps in part the fault of my own profession; though improving, we’ve historically not been very good at discussing the D word. Add the “Holby City Effect” & it becomes a very muddled topic. 2/9
So let’s forget this novel #Coronavirus for a minute and think about what #CPR is and isn’t for.
TL:DR? CPR is not a cure for natural dying. 3/9
TL:DR? CPR is not a cure for natural dying. 3/9
#CPR is of course the principle tool within the chain of survival for an Out of Hospital #CardiacArrest
We know if you have a sudden event and high quality CPR is started early, you have the best chance of a good outcome (when all the other stars align!)
4/9
We know if you have a sudden event and high quality CPR is started early, you have the best chance of a good outcome (when all the other stars align!)
4/9
Cardiac arrests IN hospital are usually quite different though.
Chances are the reason it has happened is something that can’t be easily corrected, or else it would’ve been.
(This is especially true for #COVID19 because intractable hypoxia is the most common cause). 5/9
Chances are the reason it has happened is something that can’t be easily corrected, or else it would’ve been.
(This is especially true for #COVID19 because intractable hypoxia is the most common cause). 5/9
If the CPR process does see a return of spontaneous circulation, the patient then needs to go to ICU, and faces the equivalent of a marathon to get out the other side. 6/9
If their condition before the cardiac arrest wasn’t something that was fixable by/could withstand ICU care, then it still won’t be: so ultimately the process is cruel & futile. 7/9
It’s for this reason that as doctors we make the decision Not to Attempt CPR.
It’s not because we want to withold treatment or because we value one life more than another.
It’s simply because we want to ensure our patients receive compassionate care & a dignified death. 8/9
It’s not because we want to withold treatment or because we value one life more than another.
It’s simply because we want to ensure our patients receive compassionate care & a dignified death. 8/9
So please don’t panic: you won’t be denied care based on perceptions about your disability.
Rather, your care will be planned based upon your body’s Ability.
It’s ability to deal with the malady faced, and the medicine needed to overcome it. 9/9
Rather, your care will be planned based upon your body’s Ability.
It’s ability to deal with the malady faced, and the medicine needed to overcome it. 9/9
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