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

281mustang said:
Even just telling them they're going to die is an imcompitent thing to do. .
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I disagree. You never lie to a patient. If death is obvious I will tell them while I plan to do all within my power to help them that there may be nothing more I can than help them be comfortable. I will ask if they want me to give a message to anyone in case my efforts do not work. Sometimes this at least lets them say goodbye. I will not lie to my patients or their familys.
 
281mustang said:
That should be grounds for termination IMO..
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Agree with that.


281mustang said:
Even just telling them they're going to die is an imcompitent thing to do. If the professional they trust to save their life is telling them they're going to die many of them will lose their will to survive..
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But I take issue with this.

I understand about "medical hexing" The idea that you tell a patient they will not fare well and they get depressed and don't. But there are circumstances where an alert patient has wounds or a medical condition inconsistent with life. When there are no more heroic measures because all they will do is speed death. Caring for a dying patient is just as much a part of healthcare as the biomedical part. It is not the most fun part or the most glamorous but it is equally important as anything else we do. Some will say “it is not my job.” That is utter rubbish. Palliative care is part of the paramedic curriculum. I have had to do it as a medic and if it happened to me it happens to others. (Much as I like to think I am special.)

When you accepted the respect of a healthcare provider, you accept the responsibility no matter how unpleasant the task. If you don’t, then it is time to leave.
 
Veneficus said:
Agree with that.




But I take issue with this.

I understand about "medical hexing" The idea that you tell a patient they will not fare well and they get depressed and don't. But there are circumstances where an alert patient has wounds or a medical condition inconsistent with life. When there are no more heroic measures because all they will do is speed death. Caring for a dying patient is just as much a part of healthcare as the biomedical part. It is not the most fun part or the most glamorous but it is equally important as anything else we do. Some will say “it is not my job.” That is utter rubbish. Palliative care is part of the paramedic curriculum. I have had to do it as a medic and if it happened to me it happens to others. (Much as I like to think I am special.)

When you accepted the respect of a healthcare provider, you accept the responsibility no matter how unpleasant the task. If you don’t, then it is time to leave.
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I am going to have to second this opinion. +2

Expecting a patient to repent for their sins in your ambulance is grounds for getting your ticket pulled. Read your job description, it reads that you are there to save lives, not souls. Saving lives is the medical professional's responsibility. Saving souls is the chaplain/priest/wiccan high priestess's job.

Second, watching the movie Signs will give a good example of when you must tell a patient who is alert that they are going to die. In this example a patient is impaled into a tree and pinned in between the car and the tree. Her body is severed in half and the pressure of the car and tree and keeping her from bleeding out. Once removed, she will die. This is not science fiction like the rest of the movie.
 
I wouldn't Know

I haven't had an situation where that has come up. I have had PT that said they were going to die but they were not even close. I have had a PT that has died (not in the ambulance) and not ask that question. of course thta PT was in resp distress. they also died the next day. but beside that I wouldn't know what to do. I would like to think I could come up with the right answer. But I will not know until it happens to me.
 
Veneficus said:
Agree with that.




But I take issue with this.

I understand about "medical hexing" The idea that you tell a patient they will not fare well and they get depressed and don't. But there are circumstances where an alert patient has wounds or a medical condition inconsistent with life. When there are no more heroic measures because all they will do is speed death. Caring for a dying patient is just as much a part of healthcare as the biomedical part. It is not the most fun part or the most glamorous but it is equally important as anything else we do. Some will say “it is not my job.” That is utter rubbish. Palliative care is part of the paramedic curriculum. I have had to do it as a medic and if it happened to me it happens to others. (Much as I like to think I am special.)

When you accepted the respect of a healthcare provider, you accept the responsibility no matter how unpleasant the task. If you don’t, then it is time to leave.
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daedalus said:
I am going to have to second this opinion. +2

Expecting a patient to repent for their sins in your ambulance is grounds for getting your ticket pulled. Read your job description, it reads that you are there to save lives, not souls. Saving lives is the medical professional's responsibility. Saving souls is the chaplain/priest/wiccan high priestess's job.

Second, watching the movie Signs will give a good example of when you must tell a patient who is alert that they are going to die. In this example a patient is impaled into a tree and pinned in between the car and the tree. Her body is severed in half and the pressure of the car and tree and keeping her from bleeding out. Once removed, she will die. This is not science fiction like the rest of the movie.
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I agree. After rereading my post I was probably a little too vague and should of went into more detail about that part. I was talking about in refrence to when a patient still has a chance at surviving but it's not likely. If their death is inevitable and there is absolutely nothing you can do then that is a completely different situation.
 
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Not lyng to patients, having them repent in the ambulance and writing good by notes to their family members.

My god i really am old school.
 
CAOX3 said:
Not lyng to patients, having them repent in the ambulance and writing good by notes to their family members.

My god i really am old school.
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WRONG. It's not the 50's, you don't assume everyone is a "good Christian" and wants you to preach to them.
 
my kids nanny was killed in an automobile accident after leaving a birthday party for one of my kids. when i arrived on scene, she was lying outside the car. she was alive at the time but appeared to be slipping away quickly. one look at her and it was obvious to me her chances of survival was slim. i told her i was gonna do everything i possibly could for her and asked her to stay with me.
when the helicopter arrived, she was loaded for transport. shortly after the helicopter lifted off, she coaded forcing the helicopter to divert and died a short time later.
moral of the story, i was honest with her. she didn't ask if she was gonna die but i did hold true to what i told her. being a basic, my treatment was limited. i applied oxygen, treated for shock, and packaged for transport. she was alive when she was loaded into the helicopter so i can have peace with that. i had a hard time dealing with losing her in flight but i did everything i possibly could for her on scene.
 
I'd tell him odds are you not dying in this ambulance because I'm not driving my partner is.
 
fortsmithman said:
I'd tell him odds are you not dying in this ambulance because I'm not driving my partner is.
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Its good that you understand that your partner drives better than you do.:P
 
At my clinicals this morning a lady was at the ED with a bad reaction to ace inhibitors. A younger lady in her 40's. Well she was crashing fast and was still alert. The look on her face that she knew she was going to die SOON. You would have though she saw death right there standing behind the doctors and nurses just waiting for her. It was :censored::censored::censored::censored:ing scary because I knew she was going to die. This lady had massive angioedema and nothing was working. She died in the OR within the hour. This news ruined a lot of peoples afternoon.
 
psychomedic said:
I tell them that dying is not allowed in my ambulance...
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We should never lie to a patient. If you want to see I am going to do all I can to prevent it fine. But when people know they are dieing and you lie it does not help them. And peopel do die in the ambulane all the time, just because some disregard current standards and do rolling codes does not eliminate the fact person was dead in the ambulance.
 
I would say "We're going to do everything we can for you" then ignore everything else they say.
 
The most important thing is to not lie to your patient...lying is a terrible thing in this business...anyway thats another discussion... I would tell the patient that you they have severe injuries but you are going to do everything you can to get them to the hospital where the doctors will be waiting to do everything that they can.
 
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I tell them "Not if I can help it, stay with me !!"
 
Yesterday morning I just had a seven month old cardiac arrest. It was on the borderline of the city, so both city's Fire/Rescue showed up, though we were the only ambulance there. As I am still only BLS certified, and there was two cities worth of medics in the back, I decided to excuse myself and sit up front, ready to ride hot as soon as they got the tube in and they gave me the ok. No point in taking up room as a Basic on a major call like that when you have more medics than you know what to do with.

Mom sat up front with me, so I spent a good chunk of time trying to talk her down from her understandable hystarics. Dad came to the door, and he was equally as upset, but had to be told he couldn't ride along. While we waited, I got them to calm down a little to give us some information. The little guys name, if he's been sick, what medicine he was on...

Once I got the all clear, I hauled *** to the nearest hospital trailed by our EMS Chief, a Fire Chief, the neiboring city's EMS and Fire Chiefs, and three EMS zone cars that the paramedics came in. Somehow, people still managed to not see/hear us coming, or just plain tried to "beat the ambulance" and make the turn before they could get inconvenienced by a dying infant.

The entire time, all I could tell Mom when she asked if her little boy was going to be all right is "We have two cities worth of medics back there, and they are the best we have on the ground. They will do everything they can."

He wasn't, of course. We got him into the trauma room, and I had to get Mom and Dad out of there because they kept trying to jump in there and grab their little boy. I escorted them out to the nurses station, got them some chairs, and continued to talk to them until they had a spare nurse to take them off to whatever waiting room they had. As we were doing our report and having the grief councilor lady coming by and seeing if any of us needed a debriefing session, we got word that he didn't make it and they called it at 0907. Wherever they had taken Mom and Dad, we soon heard their wailing all the way down in the Rescue room.

All in all, not a great way to start the day. But I hope, at the very least, I gave them hope without leading them on into false hope. In the end, that's all we can really do as EMT's. Don't lie, but tell the truth: That you will do whatever you can.
 
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as many have said there really is many ways to go about this. We were taught back in class out of my teachers personal experience that is they ask if they're going to die they usually sense that they are. And more than likely their right. Always be honest with them they trust you and trust that your their to take care of them so be honest. Or as some have said tell 'em not on my watch you arn't. It just varies from different person to person. so far i havn't had that happen yet. but i've heard about it.
 
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