Episode 70 End of Life Care in Emergency Medicine
Emergency Medicine Cases
Dr. Anton Helman
4.7 • 602 Ratings
🗓️ 29 September 2015
⏱️ 68 minutes
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Summary
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| 0:00.0 | Welcome to the Emergency Medicine Cases Podcast. |
| 0:05.8 | I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine |
| 0:10.5 | from EMC Studios in Toronto. |
| 0:16.1 | There is such a pertinence to having a palliative care skill set for all emergency physicians. |
| 0:23.0 | You have to establish rapport, give advice, and not get into a power struggle with people |
| 0:28.9 | who are in a crisis. |
| 0:33.3 | The real risks to resuscitation in the case that we've talked about here are around incomplete recovery. |
| 0:42.3 | It was 1995 and after a 13-hour overnight train ride, I was sitting at a rooftop restaurant in Varanasi, India, enjoying breakfast with my wife. |
| 0:52.7 | We were a few hundred meters from the famous and deeply |
| 0:55.4 | spiritual Ganges River, whose shores were strewn with burning gats, open fire pits housing |
| 1:02.0 | burning bodies. The stench of burning protein mixed with a million smells of the city drifted by |
| 1:08.2 | our table, and as I peered out toward the river, I noticed a group of |
| 1:12.5 | wheelchair-bound older folks on the neighboring rooftop laughing. I turned to the waiter, and I asked |
| 1:19.2 | what was going on there. He told me that those people were happy, because they all knew that no |
| 1:25.2 | matter when they die, they'll die on the shores of the Ganges |
| 1:28.5 | and enter the afterlife in the best possible way. You see, this was the Western equivalent |
| 1:35.0 | of a nursing home. Those people, the waiter, told me, were the luckiest old folks in the world. |
| 1:42.2 | Now fast forward to 2015 on a busy overnight shift in the ED where you have no prior |
| 1:48.3 | knowledge of a crashing patient. It's a noisy, chaotic environment, your time pressured, |
| 1:53.7 | and there's variable access to records, to family, and to advance directives. The patients, |
| 1:59.9 | a catechic 90-year-old, sent from the local nursing home. |
| 2:03.6 | The EMS told you that she's a full code. |
... |
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