88 y.o.f. w/ COPD, aortic stenosis, and Ebola presents for repair of hip Fx....

[caligas]

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Seriously, if I am called to Intubate one of these patients, I want the full body, rubber CDC suit!

 

[aneftp]

I'd declined to do the case. Unless I have reassurances my young family will be guaranteed to be taken care of in case I die or become disabled. (And I mean on way on top of my existing life insurance policy and disability policy).

 

[Yangkower]

Prop, sux, tube, priest x2

 

[Triple AAA]

Ebola what? There is a fracture, they need to fix it

 

[deleted171991]

In Spain, there were cases where people quit on the spot, rather than deal with Ebola in a non-safe environment. I would do the same, even during a fellowship. They can reassure whomever they want.

In an astronaut suit it's a different story.

 

[BuzzPhreed]

Anyone else glad they don't live in a major metropolitan area?

 

[pgg]

Ebola what? There is a fracture, they need to fix it

It is a condition I have not seen before.


Her comorbid conditions could use some optimization prior to surgery. 🙂

 

[Triple AAA]

It is a condition I have not seen before.


Her comorbid conditions could use some optimization prior to surgery. 🙂

Perhaps it is related to this 'asystola' everyone always talks about

 

[Spinach Dip]

Y'all are wimps. You evolved an immune system for a reason!

If you're gonna refuse to do one old lady because she HAPPENS to be bleeding all over the place and MIGHT be contagious, what's next? Refusing to care for the kid with a runny nose? Refusing to get near a pregnant woman who's vomiting all over the place?

THESE PEOPLE HAVE COME TO YOU FOR HELP!!!!!

 

[nimbus]

What is the life expectancy of an 88yo with aortic stenosis? 1-2 years. What is it when you add COPD and a hip fracture to the mix? Probably 6-12 mos without ebola. The likelihood of ever taking a crap independently is 1% max.

To place dozens of staff at risk to fix this fracture would be both stupid and immoral. The epitome of futile and dangerous care. We all have to die sometime. Not only would I decline this case but I would argue strongly for others not to embark on this foolishness.

We have a responsibility not just to the individual patient but also to the greatest good.

A young otherwise healthy nurse? Completely different story.

 

[Libertas]

Actually I would argue you have a duty to each individual patient you interact with, and not to the greater good specifically. Regardless, I think it's clear most of our system has nothing to do with the greater good--just look at what's spent on end of life/futile care.

 

[twoliter]

Y'all are wimps. You evolved an immune system for a reason!

If you're gonna refuse to do one old lady because she HAPPENS to be bleeding all over the place and MIGHT be contagious, what's next? Refusing to care for the kid with a runny nose? Refusing to get near a pregnant woman who's vomiting all over the place?

THESE PEOPLE HAVE COME TO YOU FOR HELP!!!!!

Yes, ebola with a 50% mortality rate is the same as rhinovirus (or allergies) and pregnancy-induced nausea. I understand you're making a point, but straw man arguments are rarely effective.

 

[Arch Guillotti]

Y'all are wimps. You evolved an immune system for a reason!

If you're gonna refuse to do one old lady because she HAPPENS to be bleeding all over the place and MIGHT be contagious, what's next? Refusing to care for the kid with a runny nose? Refusing to get near a pregnant woman who's vomiting all over the place?

THESE PEOPLE HAVE COME TO YOU FOR HELP!!!!!

Are you serious?

 

[deleted171991]

:troll:

 

[Spinach Dip]

sarcasm is apparently lost on you guys.

it's pretty funny actually.

 

[gtb]

Fortunately no hospital anywhere is going to allow this patient in the OR. Imagine a 21-day quarantine for any OR staff involved in the patient's care. The instrument cleaners would quit on the spot instead of risk infection. Probably the scrub tech too. Every elective case would be be cancelled. And just imagine finding an orthopedic surgeon willing to get close to this patient with sharp instruments, a bone drill, and a hammer in their hand. The case could only be done in a room with perfect, absolute HEPA filtration, and even then, who would clean the room, and sterilize the filter ducts and change the filters. That room would be taken out of service for weeks? Would the instruments ever be put back in to service for fear of a lawsuit with any subsequent infection from any cause. And, on, and on, and on. Long story short, not going to happen.

How about this question - Is it ethical to refuse intubating a patient with ebola until you are properly geared up?

 

[pgg]

sarcasm is apparently lost on you guys.

it's pretty funny actually.

I refer you to Poe's Law ... 🙂

I wasn't sure if you were serious or not either; you do have a history of making rather sweeping declarations regarding how doctors should interact with patients.

 

[pgg]

How about this question - Is it ethical to refuse intubating a patient with ebola until you are properly geared up?

Of course it is.

What's the very first rule/lesson of any course for the lowliest first responder? Is the scene safe; don't proceed if it's not; don't become another casualty.

 

[Spinach Dip]

I refer you to Poe's Law ... 🙂

Well I'd intubate the patient, then clean their bloody wounds myself without gloves, and lick my fingers afterwards just to show those stupid negative-sense RNA packets who's boss.

 

[Arch Guillotti]

sarcasm is apparently lost on you guys.

it's pretty funny actually.

Listen slim, the sarcasm didn't really work. No emoticons and coming from someone who isn't even in med school doesn't help either.