peter90036
Forum Elite
Topics: 24
Posts: 219
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33yo F G2 P1 at 36wks is brought in by ambulance. She is on the table bleeding profusely gushing blood spraying your labcoat in a color you think doesn't really match your socks.
You examine and she's unstable, hypotensive, severe this and that. She seems to be delirious, in and out of consciousness.
You decide its time to pop her in the OR and do some surgery.
You begin to explain this to her and she yells:
"MY RELIGION DOESNT ALLOW FOR SURGERY OR ANY INTERVENTIONS, NO IVs NO FLUIDS, NO BLOODS"
"I JUST WANNA LAY ON THIS TABLE AND IF I DIE I DIE"
"can i have a venti latte, i'm thirsty"
1. What do you do?
A. pop her in the OR
B. let her stay on the table
C. get a court order
D. send the medical student to starbucks for a venti latte
E. other.
2. What if she had normal mental status, how would that change mgmt?
3. She produces a paper that says "no interventions of any kind, any life or death situations."
Edited by peter90036 on 04/11/08 - 05:31 PM
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| grechita12
Forum Senior
Topics: 4
Posts: 145
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A is an emergency, is life threatening, so you are cover.....
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| inkspot
Forum Guru
Topics: 23
Posts: 542
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interesting case again peter.
i think she is competent: and when she says no it should be no all the way. " delirious " " dementia" " severe deppression " I THINK are exception to the rule.
b/w is it the right time to assess her mental status or treat?
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| DrVirgo
Forum Hero
Topics: 1008
Posts: 3,191
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1. Key word "delerious" = NOT competent to make her own decisions. Plus it's an EMERGENCY and there is not time to asses if what she is saying about her religion is true or not.
A. go to OR
2 and 3. in case of normal mental status or documentation: She has a right to refuse treatment and right to die if she wishes, even if she is pregnant!
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