tag:blogger.com,1999:blog-8086308.post109829565791257352..comments2023-11-05T01:30:59.840-08:00Comments on The Other Side of Ems: Chronic DyspenaAnonymoushttp://www.blogger.com/profile/12371265991241252645noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-8086308.post-35997751008907935672010-06-23T17:16:20.476-07:002010-06-23T17:16:20.476-07:00When i get out i want to become a FDNY paramedic. ...When i get out i want to become a FDNY paramedic. Well come by my site its nice.<br />Well im out.signs of heart attackhttp://www.signsofheartattack.org/noreply@blogger.comtag:blogger.com,1999:blog-8086308.post-1104798115089405992005-01-03T16:21:00.000-08:002005-01-03T16:21:00.000-08:00If Mary has a DNR order then perhaps appropriate p...If Mary has a DNR order then perhaps appropriate palliative care needs to be set up for her. ED is probably not an appropriate place to treat a patient whose condition is never going to improve and who is not for active resuscitation. She does however have the right to be free from suffering and inabilitry to breath without effort is suffering. The nursing home in consultation with her usual treating doctor/LMO should put in place appropriate treatment plans to address the problem and help Mary in what seems to be end stage COPD. If they can't cope with that task then she may need placing in a higher care facility that can deal with these problems. Either way repeatedly and fruitlessly using ambulance and emergency department resources is doing no-one any good, least of all Mary.Cameron Stephenhttps://www.blogger.com/profile/16181641789737170656noreply@blogger.comtag:blogger.com,1999:blog-8086308.post-1098574479168383512004-10-23T16:34:00.000-07:002004-10-23T16:34:00.000-07:00I strongly disagree. I think you need to ask Mary...I strongly disagree. I think you need to ask Mary how she is feeling. Tell her, "It looks to me like you are still having a hard time breathing? Do you feel comfortable going back to the nursing home?" She may have a DNR, but that does not mean that she should be discharged without her symptoms being adequately treated. If her dyspnea is that bad, she needs to stay at the hospital until an adequate medication regimen can be establish to keep her comfortable at the nursing home. Or in the other extreme, she may need to die in the hospital on a morphine drip if that is necessary to cover her dyspnea. I *love* the thought provoking situations you describe in your posts. I hope you'll keep it up.Melaina RN, PHN, MS, CNS, ACHPNhttps://www.blogger.com/profile/17368233415606799184noreply@blogger.com