RAGE Session: Do Not Resuscitate

What this episode covers

We’re ready to RAGE again! This one is 85:26 min long and includes: * Introduction… kind of (starts 00:00 min) * ‘What’s bubbling up?’ (starts 02:08 min) — Dr Smith’s ECG blog, DAS Guidelines for tracheal intubation of the critically ill, “The Human Factor” and trauma team performance. * ‘DNR’ (starts 14:58 min) — the RAGE team discuss the concept of ‘do not resuscitate’ and consensus resuscitation plans, challenges and tips for family discussions and decision-making, and a host of tricky situations (e.g. the family that wants ‘everything’, patients who want to be organ donors, suspension of DNR orders for operations, and patients with advance care plans who attempt suicide).. * ‘A blast from the past’ by Peter Brindley on ‘Joseph Lister’ (starts 80:44 min) * ‘Words of Wisdom’ from Karel Habig (starts 83:41 min) The RAGE podcast is on iTunes here and the RAGE podcast audio feed is available here. Here are the show notes for this RAGE Session : Introduction * This one features Peter Brindley (@docpgb), Karel Habig (@karelhabig), and me (Chris Nickson, @precordialthump). What’s bubbling up? * Dr. Smith’s ECG Blog * Higgs A, McGrath B, Goddard C et al. Guidelines for the management of tracheal intubation in critically ill adults British Journal of Anaesthesia. 2017 (published online) [article] * Hicks C, Petrosoniak A. The Human Factor: Optimizing Trauma Team Performance in Dynamic Clinical Environments. Emergency medicine clinics of North America. 2018; 36(1):1-17. [pubmed] “DNR” * Burns JP, Truog RD. The DNR Order after 40 Years N Engl J Med. 2016; 375(6):504-506. [website] * Patients and families that want “everything” done (LITFL CCC) * Quill TE, Arnold R, Back AL. Discussing treatment preferences with patients who want “everything”. Annals of internal medicine. 151(5):345-9. 2009. [pubmed] * Advance Care Planning Australia * Medical Treatment Planning and Decisions Act 2016 (Victoria, Australia) * Holt GE, Sarmento B, Kett D, Goodman KW. An Unconscious Patient with a DNR Tattoo N Engl J Med. 2017; 377(22):2192-2193. [article] * Cooper L, Aronowitz P. DNR tattoos: a cautionary tale. Journal of general internal medicine. 2012; 27(10):1383. [article] * ‘Unacceptable’ that families ‘not told of resuscitation plans’ (BBC, 2016) – base on an RCP audit * Doctors ‘forced’ to allow suicide (BBC, 2013) * Geppert C. Saving Life or Respecting Autonomy: The Ethical...

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