Step 2 cs scenario

[je355804]

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So, this has come up a few times in my practice and I believe others may have similar concerns...

Let us say, you are interviewing a patient in CS who has high likelihood of having a life threatening condition such as MI or less urgently appendicitis (these seem to be common conditions as least in the practice books...)

Now in the interview, I find out this patient smokes, does drugs, or doesn't use condoms in all sexual encounters etc...

This patient is at risk of developing the final symptom of life, death, if not treated rapidly. So the question is should we conduct our interview more urgently in these cases? Should we still lecture them (I know, I know... during step 2 cs it's not lecturing, it's taking the patient under our embracing bosom and coddling their every need, fear, desire... "would you like a foot massage with that chest pain sir?") about lifestyle issues even though they may die in the time we're doing so?

Opinions?

 

[Transposony]

So, this has come up a few times in my practice and I believe others may have similar concerns...

Let us say, you are interviewing a patient in CS who has high likelihood of having a life threatening condition such as MI or less urgently appendicitis (these seem to be common conditions as least in the practice books...)

Now in the interview, I find out this patient smokes, does drugs, or doesn't use condoms in all sexual encounters etc...

This patient is at risk of developing the final symptom of life, death, if not treated rapidly. So the question is should we conduct our interview more urgently in these cases? Should we still lecture them (I know, I know... during step 2 cs it's not lecturing, it's taking the patient under our embracing bosom and coddling their every need, fear, desire... "would you like a foot massage with that chest pain sir?") about lifestyle issues even though they may die in the time we're doing so?

Opinions?

No you don't have to do complete counseling in an acute case. Just mention that we will talk about ............smoking cessation.........lifestyle changes etc ............later.......... once you are better. But you must talk about how is the current condition affecting their life and what support do they have .........e.g. who is going to look after little Johnny while the pt is in the hospital and is there someone who can help with activities of daily living (grocery, shopping etc) when they are recuperating from the surgery.