You are sent to a home for a cardiac arrest. You find a patient in cardiac arrest who has been under hospice care for end-stage AIDS. The palliative care nurse tells you that some family members who were present when the patient went into cardiac arrest became very upset and called 911. The patient has been pulseless and apneic for approximately 15 minutes without resuscitation. A relative
interrupts and says she doesn't care what the nurse says; she wants you to help her brother. What should your next action(s) be?
A) Have the nurse provide the DNR, ask the sister if she was aware of her brother's end-of-life wishes, and explain that you are ethically bound to honor the DNR.
B) Provide all the interventions you can—immediate family are always able to override the DNR.
C) Explain to the sister that because the family did not start CPR right away, the chances of resuscitation are extremely small.
D) Start CPR and ACLS. Do a round of drugs, then call for orders for field termination of resuscitative efforts.
A
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