Your patients asks you "Am I going to die?"

Wee-EMT

Wee-EMT

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Your patients asks you "I'm I going to die?"
What do you tell him when you know he is most likely to die?
 
I would ask "do you feel like, your are going to die?" as impending doom is a good indicator of a serious condition. If the patient is presenting with a case of a high probability of dying, then I am inform them I am going to treat and help them the best I can and I need their help. Never lie to a patient as they can see such and will not gain trust in you. Use common sense.
 
I say "yes, we all are".
 
I say, "Sorry, not in my ambulance. It's not allowed."
 
It depends upon what is going on with the patient. The scared teen that took 2 phenergan and 3 zoloft last night at 10:30 and it is now 3:00 in the afternoon the next day - I tell them that no, they aren't going to die, at least not right now. The patients that truly have a good chance of dying, I tell, "I am going to do all I can to help you."
 
Wee-EMT said:
What do you tell him when you know he is most likely to die?
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doh3.gif
So this part of the question just registered in my brain. I guess you can disregard the first part of my answer above.
 
The moment you tell a patient they aren't going to die, they will.

It's true. Personal experience.
 
I usually have 2 answers for that question

Serious answer for the frantic/upset: "We're doing everything we can to try and keep that from happening" I'll then pop off a few "small-talk" type questions that don't require my full attention if I'm in the middle of treatment so they aren't AS focused on the situation (Trying to deter their 'emotional freak-out' as best as possible)

If they are trying to remain proud/act tough then I may throw in some humor, something along the lines of "I sure hope not, the guys won't ever let me live it down" with a smile. Then give them my serious answer above.

Real example for my humor response: Had a pt that was stabbed with a regular kitchen/dinner fork. Fork still in LUQ just below rib cage on our arrival. Pt was in good spirits on the scene and once in the ambulance asked "Am I going to die?" I couldn't answer No because its a piercing abdominal trauma and I wasn't going to answer Yes or It's Possible because I didn't want the patient to get hysterical. So with eye contact I replied "I'll tell you what, We will do everything we can to keep that from happening *IF* you promise me you'll research how to properly eat with a fork"




I won't ever lie to a patient but I want to stay away from the answer "Most likely". My ultimate goal is to keep them as calm *as possible*, whether its trying to get them focused on small talk or make them smile with a little humor.
 
TomB said:
I say, "Sorry, not in my ambulance. It's not allowed."
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I've seen someone enforce that really really strictly. One patient WAS going to die in her ambulance, she made her driver stop the truck, yanked the stretcher out and he died outside the ambulance. She said that way you don't have to stick around with the M.E? And that once someone dies in the truck, then it's "marked"

She was a little scary :ph34r:, and I don't think she works here anymore.

I've never had someone ask that, because I do IFT! Most of my patients are stable. We do get a few Non-DNR patients who try to die while you're not looking, though.
 
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I generally use the line.... "We're going to do everything we can to make sure that doesn't happen"
 
For the patient.......

This is one of those questions that will always be asked by a patient, when the patient asks this question, it does depend on the place and the time, that is for sure. I will talk to the patient and tell them we will do everything that we can for them, what is hard for me is when the family or frinds will ask that questions. Any thoughts on that??
 
Airwaygoddess said:
what is hard for me is when the family or frinds will ask that questions. Any thoughts on that??
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I usually go with the same sort of tactics. I will say something along the lines of "[Patient's name] is hurt very badly/very sick, but we are goign to do everything we can to help them until we get them to the hospital."

If family is asking that question, they typically already know what the answer is/could be. I think they are just looking for reassurance that something is being done their loved one, and a little compassion. Fortunately, I haven't had that question for family very often because I am typically busy with patient care, but I have overheard the officer in charge give a similar answer on multiple occassions.
 
as the devils advocate, what would you want to be told if the situation was reversed?
 
the truth

cause if I am somehow still able to speak and you know I am dying and do not tell me, I will haunt you forever.
 
Veneficus said:
as the devils advocate, what would you want to be told if the situation was reversed?
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I do tell the patient the truth. That I am going to do everything in my power to keep them alive. I've never had anyone I was sure was gonna die be alert enough to have a conversation with me. I've had many patients I was sure were gonna die who survived to call for my rig again and again. I do not consider myself an authority on it.
 
The ones I have had that did die were in no shape to ask. The ones that have asked are usually just run of the mill Tags. :beerchug:
 
During my ride time as a student, we had a elderly F fall and dislocate her hip. She was DNR and pretty much DN everything other then transport to hospital.

The medic let me run the call, and her v/s were at 70/40 and she held my hand and kept calling me "Daddy" and then she mumbled something about oh I can see you now Daddy. She grabbed my hand pretty hard and then gone...


That...kind of shook me up for a while...sure wasn't what I ever expierenced before, nor do I want to again...


On the brighter side, I had a older lady fall. While in transport she was all boarded c-spined up and everytime we hit a bump she told me she might throw up. I told her if she does, she better not throw up on me...

Asked her not to so I didn't have to clean the Ambulance up. And if she puked on me I would have to put a tube down her mouth. She was a jokingly lady. Arrived to hospital, moved her onto hospital bed, and BOOM! All over the RN! Smiled, gave my report, and said have a great day :)
 
We don't want people dying in our ambulances either. We do cpr and bagging until we get to the hospital. Unless they are DOA and the funeral home can't come get them.
 
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