@doctorcaldwell @RCPLondon @gmcuk @DrGrumble @DrUmeshPrabhu @acorns47 Yes so 'opt in ' only offered to clinically relevant - default no CPR
@hospicedoctor @Stephenpublic17 @doctorcaldwell Futility is a matter of judgement/opinion. Discussion is pt's only means to challenge that.
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@C7RKY@hospicedoctor@Stephenpublic17 if patients want to discuss DNACPR status the situation is very straightforward, almost easy.Thanks. Twitter will use this to make your timeline better. UndoUndo
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@C7RKY@hospicedoctor@Stephenpublic17 in 34yr inpatient work I can only recall 1 patient initiating that DNACPR discussion with meThanks. Twitter will use this to make your timeline better. UndoUndo
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@C7RKY@hospicedoctor@Stephenpublic17 that's despite leaving many openings "Anything else you want to ask? Need to know? Etc" -
@doctorcaldwell@C7RKY@hospicedoctor@Stephenpublic17 >ask 'is there anything else that could be considered that you hv not discussed w me' -
@katemasters67 like seeing financial adviser "give your £ to your children" then ask him "Why didn't u advise me buy £1m of lottery tickts?" -
@doctorcaldwell maybe doctors could use same method- give a risk factor for individual patient to explain why it's not being offered? -
It’s possible to calculate risk factor for every patient on admission using age, sex, emergency, 1st Dx, etc
@katemasters67@doctorcaldwell -
@Jarmann@katemasters67 very difficult most clinical coding completely overlooks severity+factors such as immobility, incontinence "frailty" -
Only the Japanese hospital data includes that - on admission they record Activities of Daily Living (ADL).
@doctorcaldwell@katemasters67 -
@Jarmann@katemasters67 I wonder how Japanese culture approaches DNACPR "decisions"? - 1 more reply
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@C7RKY@hospicedoctor@Stephenpublic17 in NHS patients are always meant to have a right to a second opinion, and should ask if they want -
@doctorcaldwell@C7RKY@hospicedoctor@Stephenpublic17 that's not widely known to patients.
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@C7RKY@hospicedoctor@Stephenpublic17 in 34y NHS work I have more often suggested patient has a 2nd opinion than patients asking for one -
@doctorcaldwell@hospicedoctor@Stephenpublic17 Appreciated, but pt can only know they need a 2nd opinion, if informed that the 1st exists.
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