•A 67-year-old woman has suffered a massive subarachnoid hemorrhage. The patient was well until three days prior when she had a sudden loss of consciousness. After emergent transport to the local hospital where her trachea was intubated and a CT scan disclosed a large grade 4 subarachnoid bleed, she was transferred to the intensive care unit. Over the past 72 hours her condition is unchanged. She in nonresponsive to deep painful stimulus, there is no dolls’ eye or gag reflex, and corneal blink reflex is absent. She has had no narcotics, analgesics, or paralytics. There is discord present within the family about whether to withdraw care. The husband desires care to be withdrawn whereas the children want to continue maximal supportive care. You explain that the most important determining factor in helping to direct future care is
A. the decision of a court appointed legal guardian •
B. the decision of the medical and nursing team taking care of the patient •
C. the husband’s wishes given that he is the health care proxy •
D. the opinion of the hospital ethics committee •
E. the patient’s previously expressed wishes regarding life support if known
e
archer when will u post the answers?
B . the decision of the medical and nursing team taking care of the patient •
Subject is brain dead.
i would like to know the answers for the questions…..when will u post them archer??
e
E
e
B
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E
please post the answer.
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Answer is E.
In these difficult situations where the patient is not able to make their own decisions and when there is disparate views among family members, the most important directing factor should be what the patient would have decided were they able to speak for themselves. Therefore, previously expressed views on what the patient would want if faced with a similar situation could prove invaluable in helping to direct care in the direction that the patient would have wanted. Court appointed legal guardians (choice A) are utilized when a patient has no family or has family members who are not competent to help make medical decisions on behalf of the incapacitated patient. If the patient has a clearly expressed view, this view would supercede any sentiments by the medical team (choice B), the husband (choice C), or a hospital ethics committee (choice D).
question. the patient per the exam seems to be brain dead. an apnea test should be performed, which, if the patient fails it, then what? What are the rules for brain dead patients?
E
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E- Is the correct answer. In case similar to this, always try to the patient’s wishes.Remember patient autonomy.