Many other states have implemented a "POLST" Program which directs physicians and healthcare providers regarding end-of-life care. These forms are called Physician Orders for Life-Sustaining Treatment (POLST). They have been met with great success in other states such as Oregon, California, West Virginia and Wisconsin. Here is a link to a sample form.
POLST forms directly address the patient's "DNR" or Do Not Resuscitate status very clearly. Often times, while a patient may already have an Advanced Directive or Living Will, these documents do not address what to do if the patient has no pulse and is not breathing. How many times have we seen elderly debilitated nursing home patients transported to the emergency department receiving CPR, intubation and life-sustaining treatments? Ambiguity regarding end-of-life issues leads to inappropriate (although well-intentioned) treatment by providers when the patient or family may wish otherwise.
These forms address CPR, medical interventions (such as IV fluids), antibiotics and artificial nutrition.
As emergency physicians, we need to stand up for our patients and families and champion these end-of-life issues.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment