Makes no sense to me. Surely Consultant A wouldn't discharge a terminally ill 2yr old boy marked DNACPR who had suffered an arrest that very day, only to be inappropriately saved by CPR being wrongfully carried out, despite BG's attempts to stop them? See where I'm going?
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Paeds resus isn’t usually CPR initially. Most arrests are respiratory: so would be managed by giving respiratory support initially, which can be enough to prevent the heart stopping and chest compressions aren’t needed. We don’t know what happened with the other little one >
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Replying to @gourmetpenguin @C7RKY and
<but if there was an airway blockage or the child had stopped breathing, then airway clearance & bag/mask ventilation would be the resuscitation. Most of our patients want to go home at the end of life, so would discharge - even if they’d had a respiratory event
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Fair enough. I didn't appreciate that. Although if she felt the need to intervene to stop them because of a DNACPR, does that not imply it was CPR she was stopping?
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Nope. Resuscitation is ABC: airway management (can be as simple as repositioning the child, or clearing out secretions), breathing (a few breaths is sometimes enough), and THEN circulation
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Replying to @gourmetpenguin @C7RKY and
It’s the same problem isn’t it: things that are “obvious” to me aren’t that obvious (huge differences between Paeds & adult care)
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I appreciate that's your approach (now you've told me, anyway!) but a DNACPR doesn't affect any of those things. Only CPR would justify her intervening, surely?
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We usually write a treatment escalation plan alongside: would the child have airway management or not; sometimes it’s AB but not C; would we put a cannula in or not. Depends on each child
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Hmmm... thank you. That was very helpful. Still have an uneasy feeling attached to these events which I haven't shaken yet, but that adds huge detail I didn't know. Much appreciated
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Can’t help thinking this would have been a lot less painful for family if someone had sat down with them and gone through things earlier :(0
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I'm going to file that one under 'words that could've come out of my mouth'. :) I've regularly tweeted this out over the years & this seems like as good a chance as any to do it again. I'd make it a compulsory element of annual CPD to watch this if I couldhttps://www.youtube.com/watch?v=qmaY9DEzBzI …
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