Pre op assessment and DNR question

Covering their backs against legal action.

Cases have been brought where patients who have been resuscitated have sued over broken ribs or where a family sued because the patient was brain damaged through lack of oxygen before resuscitation and then needed ongoing care.

As a medical practitioner you’ll know the risks that come with resuscitation.

They now have a record of your decision and you are responsible for the outcome of your decision.

Medicine’s a minefield.

I had a partial knee replacement at a private hospital 3 weeks ago. I am 68 and was not asked about DNR.

Seems very strange to me, not usually routine unless you have a life limiting illness.

you could query their policy on this.
via complaints procedure.
good luck, and with the op.

It is something you should think about. I have one in place.

I was asked very recently when I was in hospital ,I said no .I am 77 .

My friend didn’t sign this document before her heart operation last year aged 69. She had to be resuscitated during the op, We still meet up for our weekly walks but I wonder if I would have lost a friend if she had signed the paper.

I have absolutely no problem with being asked. Surely it is best to ask- rather than take a pop at guessing if and when.

My DH was asked this whilst in A&E last June. He was going to be admitted for treatment. He said no. He was 82 at the time.

I have a different take on this. My uncle was operated on a 6 years ago he told them he didn't want to wake up if the cancer had spread to far. Because they didn't get him to sign a DNR form he was put on life support due to complications during the operation. My cousin's had to make the decision to turn the machines off.

My cousin and his wife talked about what would happen if the same thing happened to them. And decided that they would not put the family through the trauma of having to decide to switch the machine off. Unfortunately my cousin's wife got dangerously ill and because of knowing what her wishes where she died at the age of 53 4 years ago.

My aunt had died 20 years ago . Because of her lungs she was told she would have to live the rest of her life on respirator she said that was no life. She died at 61.

My daughter knows my wishes because of my health if I become seriously ill or have an operation and I won't be me anymore or have to spend the rest of my life dependant on someone to look after me I don't want that.

Quality of life is what counts to me not quantity. I talk from experience my husband had grade 4 malignant melanoma which gave him 6 secondary tumours and died at 47.

It's a talk we should all have with our loved ones. It's hard but it is important.

Well said Whiff.

Whiff speaks wisely. Before making the decision to resuscitate I would urge everyone to have a clear idea of what it actually entails.

It is not like the television! It is brutal and usually involves injuring the body painfully and sometimes severely. There can be permanent effects upon the brain too.

I have, unfortunately, been in the position of having to deal with resuscitation issues for several members of my family.

The first time was for my mother, nearly forty years ago. Nobody in the hospital asked and so she was resuscitated although she was only days away from dying of cancer. All that was achieved was a few more days of agony not only from the cancer but from resuscitation injuries.

I was thankful when my husband, also dying from cancer, was adamant that he should not be resuscitated.

My sister arrested during a heart operation and was resuscitated. The stress of resuscitation caused a massive bleed in her brain and she was put on life support. I had to make the decision to turn it off. My big fear was that she would be kept in a coma, brain dead, and that I would have to go to court to end her life.

People think of course I would want to be brought back to life, but it is very unlikely to be life as it was before. The lack of oxygen even if resuscitation is successful, has consequences for the brain and all resuscitation techniques have consequences for the body.

I certainly would not want to be resuscitated if I arrested outside hospital. It might be different during a heart operation as difficulties are expected and instant resuscitation available. I think I would want to know the risks involved in the operation before making that decision. Also clarify the difference between DNACPR and DNR, as the latter can sometimes mean no life prolonging treatment such as antibiotics at all.

Well lots of differing opinions and of course everyone has different circumstances.
Yes a medical minefield I agree as I have been at resuscitations and they are pretty brutal.
BUT......my father had a cardiac arrest at age 54, he was successfully resuscitated and had two more cardiac arrests over a few years. After a heart bypass at age 59 he lived a very active life until he was 83. If he had been left to die I would have lost my Dad when I was only 27 which would have been devastating for my Mum, sister and brothers and my two young children.
If I had a terminal or life limiting illness I would have no hesitation but I do not and that is why I was shocked.
I will definitely ask the policy of the hospital and clarify it all.
Thank you all for your views and the good wishes from welbec........

Before my last knee replacement in 2018, I brought up the subject with the consultant and colleagues who re-assessed everybody again on the day of surgery. I said in a jokey way I would have DNR tattooed on my forehead. Although I was not given a form to sign, I was 75 at the time, they were well aware not to try too hard. I was fine.