Here ’s what you learn when a young patient dies

“This is a 17-year-old boy who came in as a category 1 trauma yesterday for a rollover MVC with bilateral uncal herniation, epidural hematoma and subdural hematoma currently intubated and sedated with propofol and fentanyl.” As the overnight resident presented this patient on PICU, we could see everyone’s early morning smiles fading slowly and beginning to understand the grave consequences anticipated in this severe traumatic brain injury. We could see the wheels churning in the doctors’ brains, emotions churning in parents’ minds and tears turning in the rest of the family. The family understood how severe this injury was, but they kept saying, “We are hopeful.” In the upcoming days, we would talk about the numbers and adjustments we would want to do that day. We would talk about how many boluses of the sedative he needed. We would talk about his central DI, terrible gases that he had and various ventilator settings we wanted to correct for those numbers. Then we would translate everything to the parents. We would tell them that we need to decrease his metabolic needs and give as much oxygen as possible to his brain. Eventually, we would ask, “Is there anything else that we can do?” Every time we would hear, “You can’t give me the one thing that I want, and that is to bring my son back.” Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Critical Care Pediatrics Source Type: blogs