Patient coherent:
“Have you talked with your primary care provider, family or friends about your wishes for emergency care if you were not able to speak for yourself?”
Have you ever completed an advance directive for health care or a POLST form? Do you remember what the advance directive / POLST said?”
Develop an understanding of patients’ overall prognosis and likelihood of surviving CPR so that patients can make informed decisions and you can make the appropriate recommendation surrounding CPR
Suggested language: “What is most important to you at this point in your life?” “What<unk>  do you have for the time you have left?”
If you think CPR would be futile, some suggested language is:
“Based on what you have said, I think we should continue all of the treatments you are currently getting, and provide all basic medical care such as antibiotics. I also think we should ensure you have a lot of support for pain and any other symptoms you experience. I do have some concerns about other treatments that might be offered. May I share those concerns? I’m worried that resuscitation and life support won’t help you get home if you became very ill; it’s unfortunately not likely to be successful, but even if you were resuscitated you would likely be in the ICU, potentially dependent on machines, and with a very different quality of life than you have today. Many patients at your stage of illness decide that as opposed to trying resuscitation or life support, they’d prefer to allow a natural death when that time comes. You don’t have to decide right now, but I’d appreciate hearing your thoughts.” (Code Discussion Status by Rachel Stern)
“Have you talked with your primary care provider, family or friends about your wishes for emergency care if you were not able to speak for yourself?”
Have you ever completed an advance directive for health care or a POLST form? Do you remember what the advance directive / POLST said?”
Develop an understanding of patients’ overall prognosis and likelihood of surviving CPR so that patients can make informed decisions and you can make the appropriate recommendation surrounding CPR
“Based on what you have said, I think we should continue all of the treatments you are currently getting, and provide all basic medical care such as antibiotics. I also think we should ensure you have a lot of support for pain and any other symptoms you experience. I do have some concerns about other treatments that might be offered. May I share those concerns? I’m worried that resuscitation and life support won’t help you get home if you became very ill; it’s unfortunately not likely to be successful, but even if you were resuscitated you would likely be in the ICU, potentially dependent on machines, and with a very different quality of life than you have today. Many patients at your stage of illness decide that as opposed to trying resuscitation or life support, they’d prefer to allow a natural death when that time comes. You don’t have to decide right now, but I’d appreciate hearing your thoughts.” (Code Discussion Status by Rachel Stern)
Patient not coherent
Family members present?
POLST with family?
Paramedics brought POLST from patient's home?
Review of previous hospital records regarding Code Status (can ask RN to do so while you are coding the patient).
Family members present?
POLST with family?
Paramedics brought POLST from patient's home?
Review of previous hospital records regarding Code Status (can ask RN to do so while you are coding the patient).
Goals of care
End of life care
Sign out tools
Explosive incident response
Tactical field care
Creative Commons
Poison control
Critical care documentation