QUESTION:
Is it OK for doctors to make unilateral decisions to limit life-sustaining therapy (eg, remove a ventilators) without patient/family discussion?
2/ Variable Approach to Limiting Life Sustaining Treatment for ICU Patients
N=12,850 patients in ETHICUS-2
% “NO DISCUSSION” at EOL was 2% in North America vs 37% in Latin America
1st meet @pamelarbishop, a scientist in forced early retirement due to LC:
“I oscillate between fierce determination to get better & abject horror at the daily destruction of my body."
read on…
2/ A case-control study of 9k unhospitalized COVID pts treated w Paxlovid btwn March & June 2022 versus 47k patients w no antiviral or antibody treatment.
📌 Not so fast
📌 Study of N=1000 backs-up our MIND-USA study - full 🧵👇
📌 Haldol doesn’t treat #delirium
📌 Calms pts & can ⬇️ danger
📌 Delirium care is about non-pharm approaches - the Dr. DRE…
1/🧵What do ICU survivors tell me about PICS…(post intensive care syndrome)⁉️
Former ICU patient: “I’m angry. I’m furious because the doctors who injured me aren’t willing to help me recover.”
Is this fair?
I think so.
Why?
Read on…(perm to share)
2/ I just got off the phone w a patient who has had PICS for 12 years since nearly dying in the ICU. His story is included in #EDDB…he granted permission to share some thoughts today that I think are eye opening…in terms of how poorly we’re doing w Chronic Disease management
3/ people who never had PTSD before critical illness, leave with inexplicable experiences of road rage, rejecting their spouse, acting in ways that are so foreign to them that they don’t recognize themselves.
They also have tremendous problems with lack of self worth because…
2/ It’s one thing to concede that Long COVID exists as a societal problem for those w vulnerabilities like advanced age, pre-existing health conditions, or nearly dying in ICU.
What about nationally ranked D-1 long-distance runners⁉️
3/ Alex Schell is 21 & based his life decisions on making the 2024 Olympic trials.
“Not only can I not run due to #LongCOVID, I’ve also lost everything I hoped for. Who I envisioned myself to be is a past idea. It’s a monumental loss.” (story w perm)