Casey\'s Last Inninjg Casey, a forty-seven year old woman, umpired little league
ID: 137270 • Letter: C
Question
Casey's Last Inninjg Casey, a forty-seven year old woman, umpired little league baseball games until she apparently suffered a cardiac arrest six months ago. She suffered anoxic brain damage and is now in a persistent vegetative state. Her mother, who lived with Casey until her illness, insists on aggressive treatment despite the poor prognosis.The nursing home staff has reluctantly agreed to CPR. About midnight, staff discover Casey to be without pulse or respiration. Medics are called (911) and the rescue squad arrives within six minutes. During this time the nursing staff initiate CPR. After twenty minutes of unsuccessful resuscitation, Casey's physician is called for instructions. The doctor orders that the resuscitation efforts be continued, and that Casey be transported to a nearby emergency room. The nursing staff is reluctant to carry out this order. The rescue squad is willing to proceed. The physician is not willing to come to the nursing home to supervise the resuscitation attempt. QUESTIONS 1. When Casey was transferred from the hospital to the long-term care facility, a window of opportunity to discuss treatment redirection was apparently missed. Create the conversation that could have taken place. 2. As the director of nursing on the night shift, your are the one who calls the physician for instructions. How might you be more assertive in this exchange?Explanation / Answer
1 - as the pulse of the patient were not detected thus only CPR is what we can do , do CPR for 20 min to generate the impulse in the heart chambers of the patient, try as much as you can we can save her by this method , once impulse are generated with will proceed to medical treatment
As the director on the night shift , I call the physician to check the patient because there are no pulse detected and the patient already experienced a heart attack 6 months ago, this is a very serious case and must be seen by the physician ASAP .