DrVenu's Broadcasts

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Dear Faculty 
Kerala sociocultural scenario is totally different from other parts of the state .  A huge number of our population are working abroad or away from core family . Parents are alone in many families . Renal disease , Cancer ,Complicated diabetes , COPD , Stroke , CAD etc are so rampant in our state . Old age and related issues are common . Emergency departments has got its own impact due to this health profile. Emergency doctor has likely to phase a lot of decision issues and forced to a huge emotional interface while managing patients with end stage diseases . Each one of you should learn how to de-escalate aggressive EM approaches and higher end resuscitation mode to comfort care . You must receive special training in this field . As you know we can not document DNR in case sheets . What we can document only as "palliative care only " . But this decision should come from primary physician and he should take this decision after discussing with blood relatives of the patients in a joint meeting with all concerned . In such cases no need to call Code blue . If at all you come across such a code blue , you must communicate with primary physician and de-escalate your resuscitation process which confine to BLS level and no need to rush lab and imaging studies .  Obviously you must escalate into effective communication mode . You must follow  7 C s of of comfort care  here "Confirm, Communicate ,Consent,Consolidate ,Consider,  Confine , Concerns and Conclude " 
Dr Venu 1.12.16

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