Kathryn Mannix πŸ’™ Profile picture
Palliative Care Physician passionate to get us all better acquainted with the idea of dying well. Sharing ideas, not necessarily endorsing them. Rep: @DHAbooks
13 Jun
Timely CPR saved Chris Eriksen's life.
The match footage shows
-how immediate collapse is after #CardiacArrest
-how quickly we need to respond
In Cardiac Arrest the heart stops while other organs are healthy: rapid CPR response saves lives.
Learn CPR: see @ResusCouncilUK
There has been criticism of TV companies broadcasting footage of Eriksen's on-pitch collapse. I wonder what he will say when he is ready to comment.
I hope the footage drives better public understanding of CPR & a wider uptake of CPR training.
CPR training must include info on success rates, & explain when NOT to attempt it. CPR is entirely appropriate when the heart stops first: it gives brain & other organs their best chance of preserving function. Early, effective CPR by trained people may save 1 in 5.
Learn CPR!
Read 14 tweets
5 Jun
#MedicalTwitter, this is not OK.
Please look at this story, & the responses, to see the uphill struggle we have to talk with compassion about CPR to people who are sick, frightened & not accompanied by their loved ones during this time of covid.
Some comments:
Firstly, I have been the doctor whose words were relayed by a v sick patient to a relative, & what the relative heard was not what I said. But it WAS what the patient/family understood from what I said, so I was responsible for that miscommunication.
Communication matters.
CPR isn't really 'treatment.' It's a bridge to treatment in an emergency. Sometimes it works. But it's not like on TV.
Most people don't know that, so how we explain it really matters.

Read 17 tweets
22 Apr
How should we help teenagers to understand and accompany a dying relative?
Here are some ideas and suggestions: I know the experts on Twitter will come in to support @healinghappily in her quest to be as ready as she can be.

A thread.
First: there's no 'right answer.' Your teens are individuals, and what suits one may not sit well for another.
Good support is a mixture of access to good information, lots of listening, & giving them choices.
Support includes helping them establish their own support network & self-care choices. Your own Mum is dying: you may not always feel able to be their sole support.

1. What can they do to keep themselves well? Hobbies, exercise, confidantes, good food: discuss & plan with them.
Read 20 tweets
26 Aug 20
Deathbeds. Some thoughts. A thread.

Most of us haven't seen somebody die in real life. We get our inner pictures from TV dramas, cinema screens, media stories. We've had more of those media stories than usual during Covid19. But we haven't been there for real.

Worse: for some of us, our beloved person died and we weren't allowed to be there. We have pictures in our minds of how it might have been, but no way of knowing for sure.

Some of us work in health or social care. We're more likely to have been alongside dying people. But unless we recognise the process, then we may not understand what we are witnessing.

Some experienced workers aren't aware that there are similarities between most deaths.

Read 25 tweets
15 May 20
Looking at the future, as you grow older or your health deteriorates:
🌈 What's your best hope?
😱 What's your worst dread?
πŸ‘£ What steps can you take now that will help to ensure the future is closer to 🌈 than to 😱?
Who will you need to talk to as you think about what steps to take? e.g.
Family &friends: people who have your wellbeing in mind.
Medical advisers: people you trust to give you truthful information.
Rights advisers: people to ensure your concerns receive a fair consideration.
What do you need to find out?
🧭 The likely direction of your future health. How will it affect your independence, mobility, thinking, ability to do the things you love?
🧭 Any predictable health emergencies? Options for how these can be dealt with.
Read 17 tweets
9 May 20
Before #COVID19 I tended to think bereavement support was not integral to palliative care, fearing we might 'medicalise' grief.
During a period when family life is disrupted & beloveds are separated at death, prioritising bereavement care is essential - it starts before death.
Making sense of a death in our bereavement requires us to be able to understand the story of the dying.
This is why people bereaved by disasters need enquiries & information. They need to construct the narrative of their dying loved one's final days, hours, minutes.
Making sense of our beloved's final part of living helps us to complete their story.
Those 9/11 messages from the Twin Towers & UA flight 93 gave us insights into the experience of those people as they faced death.
Their calls mention fear & sorrow, yet also love & thanks.
Read 7 tweets
15 Mar 20
This is the time to have those tender conversations.
Not out of panic.
Out of love.
If you want to understand each other's wishes, here are a few questions to ponder together.
There are no right answers.
The only wrong answer is silence.
Here's @doctor_oxford's calming but important discussion of why we need to talk about dying:
We're all trying to minimise the risk of our most vulnerable citizens contracting the virus.
Let's all minimise the risk that any of us who get very sick end up with intrusive treatments that we didn't really want.
Some of us already know we don't want to go to hospital.
Read 13 tweets
27 Feb 20
What do we need to know now, to protect the wishes of our loved ones at the end of their lives?
Great question @tdeweymarn @DrMariMcV
I feel a thread coming on...
Before you start, remember this conversation is theirs as much as yours:
- invite, don't compel.
- give them options about when to have this conversation, where to have it, how long to give it
-have a plan for after the chat: cuppa, favourite TV show, walk, hobby etc
There are some things that seem huge, but can be surprisingly simple.
There are some apparently trivial things that can assume huge proportions later on.
These can vary from family to family.
If it feels delicate, ask if it's ok to continue.
Read 21 tweets
3 Feb 20
Here's a cry from the heart. #eol Twitter, this is so real: @chippety knows this is the dying time & can't deal with books, articles, long diatribes. This is about getting to the heart of supporting our loved ones at the end of life.
Practical things:
Where will he be cared for? How can companions ensure he has company when he wishes, time to rest, help to move around? Support for his dearest people? Help with laundry, shopping, meals?
Make a list of jobs.
Write rotas.
People want to help but don't know how.
Plan ahead things:
Does he have a named person as his Health Attorney in case he can't speak for himself some days?
Takes a few days to get all the signatures & register the form: gov.uk/government/pub…
Read 20 tweets
31 Dec 19
@thetestlabsio I tried to respond to your question with a thread of 10 tweets, but somehow they seems to have become jumbled. I'm re-posting below: slightly generic answers, because so many people ask exactly what you are wondering, and I hope it might help them, too.
Thread ⬇️
I wish someone could have explained her dying to you as it was happening. This might help:
1. Most people move into deeper unconsciousness as the process of dying proceeds.
2. To begin with, they are simply tired & need more sleep, dozing between short periods of being awake.
3. Gradually, they lose consciousness, initially only for short periods during sleep. They report 'good sleep.' We don't know when we are unconscious.
4. When the brain is unconscious it reverts to automatic breathing cycles: alternating deep/shallow, fast/slow, in cycles.
Read 11 tweets
6 Aug 19
Some patients are sick enough to die. They may pull through. They might not.
Say 'sick enough to die' to pt & family. Not 'serious.' Not 'critical.' Not 'unstable.' Name death as a possibility, & plan good #eol care in parallel with current treatment plan.
If your patient is sick enough to die, get support from your seniors &/or pall care team.
Patients who see the pall care team are not obliged to die.
Pall care can help you with parallel planning, support pt/family/staff (you!), in ER, wards or ICU.
A common complaint from families when patient dies is 'we didn't realise s/he might die!'
They are told about sepsis/low oxygen sats/hypotension/poor blood supply to vital organ(s) but this doesn't communicate 'sick enough to die.'
Use your D-words.
Read 5 tweets